Hyperuricemia, better known as gout, is a disease characterized by increased uric acid production that causes the accumulation of uric acid crystals in the joints.
Uric acid is produced to break down substances called purines that are high in meat or shellfish. Once its function is performed, most of this chemical dissolves in the blood and is expelled through the urine.
The problem comes when the levels of this chemical in the blood are higher than 7mg/dl, because at that moment it forms the famous crystals that are deposited in the joints.
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The big toe is the area where these crystals are most frequently deposited, but not the only one. Gout can also affect the instep or ankle.
The main symptoms of hyperuricemia in the affected joint are:
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Inflammation
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redness
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Pain, even with the slightest touch.
The discomfort usually starts at night or first thing in the morning.
800,000 affected in Spain
According to the data carried out by the , the prevalence of gout disease in Spain is 2.4% of the adult population, which is equivalent to approximately 800,000 affected in our country. Of these, 66.6% are patients over 60 years of age.
And as indicated by the Dr. Neus Quilisrheumatologist from Elche:
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“These data are higher compared to those of other neighboring countries (except the United Kingdom, which is similar) and an increasing trend is observed, probably in relation to greater age and changes in lifestyle. In addition, it has been observed that hospitalizations for this rheumatic disease have been increasing in recent years”.
This expert points out that, although it is a very common disease among men, “women can also suffer from gout, although it usually appears after gout, probably because estrogens cause lower levels of uric acid in the blood.
In older women, a not infrequent form of involvement occurs in the fingers of the hands.
gout can be cured
Regarding patients, the specialist insists that
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“There are recommendations regarding the Lifestyle that can be followed to reduce the chances of having high levels of uric acid in the blood.
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“To prevent we must know that, in general, following a diet rich in purines of animal origin (red meat or shellfish), alcohol (especially beer) and drinks rich in fructose will increase the possibility of having hyperuricemia and gout.”
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“The latest guidelines also recommend promoting a heart healthy diet and maintain weight control.
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“For patients already diagnosed, it is essential to follow the Pharmacotherapy prescribed by your doctor.”
But point 4, which should be great news, becomes the pending issue of this disease. Because it is precisely the lack of adherence to the treatments that prevents ending up with a disease that can be cured.
This is what the doctor Diana Peiteadoof the Rheumatology Service of:
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“Gout can be cured by achieving the complete disappearance of urate deposits and controlling uricemia. However, despite having effective therapeutic options and greater knowledge of the pathophysiology of the disease, control in real practice is far from to be the right one.”
To eliminate excess uric acid in the blood, the rheumatologist Peiteado emphasizes that:
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“It is essential to continue working on adherence to hypouricemic drugs, as well as promoting lifestyle habits that improve gout and the proper management of its associated comorbidities.”
In addition, -he added- “advances such as ultrasound can offer a better diagnosis and follow-up of patients with gout, so the training of specialists in this technique should be promoted”.
Inpatient impact and resources
The increase in those affected and the lack of control of uric acid levels have another worrying consequence, which is the increase in hospitalizations due to gout.
Dr. Peiteado explains the results of a study carried out between 2005 and 2015, which revealed that:
“The national hospitalization rates of the gouty population gradually increased from 35 cases per 10,000 inhabitants per year to 50 cases per 10,000 inhabitants/year, an increase in hospitalization similar to that of other countries.”
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“83% of hospitalized gouty patients were male, with a mean age of 72 years and a significant burden of comorbidity.”
The impact on the health resources of patients with gout is due to their high morbidity that causes a significant number of medical visits and drug prescriptions, especially in the field of Primary Care, and to a lesser degree in specialized care.
In addition, “we must highlight the frequent association with other diseases, especially with cardiovascular risk factors, which appear in much higher percentages than in the general population.”
“In fact, it is the most prevalent inflammatory joint disease with the most associated comorbidity,” he specified.