Cardiovascular and metabolic comorbidities associated with rheumatic diseases: focus on hyperuricemia and gout

Cardiovascular and metabolic comorbidities in patients with rheumatic diseases (RD) determine the risk of adverse outcomes. Gout is one of the diseases which significantly increase the cardiovascular risk (CVR). The authors present a literature review elucidating the prevalence and spectrum of cardiovascular (CVD) and metabolic diseases, as well as the proven CVR factors in persons with RDs, including gout. As demonstrated, the increased CVR amid RDs is caused not only by a higher prevalence of the traditional CVR factors but is also related to multiple specific disease-associated risk factors. Chronic systemic inflammation, the development of internal organ lesions and the long-term use of anti-inflammatory therapy contribute negatively to the overall CVR. Thus, RDs are considered as important CVR re-classifiers and require a compulsory revision of the risk factors. Currently, the national and international guidelines for the CVR prevention in persons with RD have been developed and used in practice. Among RDs, a special place is held by gout which is characterized by common cardiovascular comorbidities and reduced glomerular filtration rate. The recent studies have demonstrated that in the management of patients with hyperuricemia (HU) and gout it is necessary to achieve a sustained target level of uric acid for preventing adverse effects on the organ systems and reducing CVR. Among the recommended therapeutic options for patients with cardiovascular and renal comorbidities, the preference is given to febuxostat, a urate-lowering drug with high activity and proven safety. KEYWORDS: comorbidities, rheumatic diseases, gout, cardiovascular risk, febuxostat. FOR CITATION: Babaeva A.R., Kalinina E.V., Zvonorenko M.S. et al. Cardiovascular and metabolic comorbidities associated with rheumatic diseases: focus on hyperuricemia and gout. Russian Medical Inquiry. 2023;7(3):150–159 (in Russ.). DOI: 10.32364/2587- 6821-2023-7-3-150-159.