Computer-assisted analyses show 47% of the 2152 patients of gout have associated medical conditions. Hypertension occurs in 25% of the patients; ischemic coronary heart disease, cerebral or peripheral circulatory insufficiency in more than 10%. Proteinuria is present in 20%, with renal insufficiency in <10% Maturity onset type of diabetes is in about 6%. Obesity or hyperlipidemia is found in >30%.
About 1/3 of the patients have one associated medical condition only, 12% with 2, 6% with 3 or more. Mean plasma urate in patients with 0 complication is 9.2±1.5 mg/dl. It steadily increases to 10.2±1.7 mg/dl as complications increase to 3 or more. Tophaceous deposits increase from 25% with 0 complication to 37%, 45% and 51% with increased number of complications; renal calculi increase from 20 to 34%. Increased number of acute gouty arthritis at times becomes protracted. Drugs for gout and for complications sometimes create undesirable side reactions.
Survival rate with long term follow-up shows steady decrease with increasing number of complications. Only 20% of the patients at death had no known complications. When present, they died at earlier ages.
The management of gout nowadays may seem to be simplified. In fact, it is not necessarily so, when one considers the management of the various complications, clinical as well as choice of drugs, etc.