What gout and heart failure have in common

An estimated 6 million Americans have heart failure, a condition when the body stops adequately pumping blood through the body. The condition is responsible for about 86,000 deaths in the U.S. each year.

Heart failure is frequently accompanied by gout, a painful type of inflammatory arthritis caused when uric acid crystals build up in the joints. One link between these two conditions is high levels of uric acid, which can increase the risk of coronary artery disease and heart-associated death.

However, another common thread that’s sometimes overlooked is chronic inflammation.

“Heart failure is more than just a failure of the pumping function of the heart,” says Dr. Sula Mazimba, a UVA School of Medicine researcher and cardiologist specializing in heart failure. “There are other processes that are involved, especially during an acute hospitalization phase such as elevated inflammation and neuro-hormonal process.

“Many of the therapeutic agents for heart failure target neuro-hormonal pathways, but few if any target inflammatory pathways,” Mazimba added.

The paradox here is that drugs like steroids and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, while often used to treat gout, aren’t typically given to heart failure patients. This is because these medications can worsen heart failure symptoms like fluid retention.

But there is one medicine used for gout that may have potential for heart failure as well…

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The dual power of colchicine

UVA Health researchers examined the records of more than 1,000 patients who were admitted to University of Virginia Medical Center over a nine-year period for worsening heart failure. Some of these heart failure patients were also experiencing an acute gout flare, while others were not. And some of those experiencing gout flare were treated with a well-established gout therapy known as colchicine.

They discovered that heart failure patients experiencing a gout flare who received colchicine had a survival rate of 97.9 percent, compared with a 93.5 percent survival rate for those who didn’t receive the medication.

“Colchicine is a medication that has anti-inflammatory properties that could potentially attenuate the heightened inflammation that we see in patients who are hospitalized with heart failure,” Mazimba says.

The researchers believe that by moderating inflammation in the heart and blood vessels, colchicine may improve outcomes, especially in the acute phase of heart failure hospitalizations.

“These results highlight the importance of novel inflammatory mechanisms in heart failure,” says Dr. Kenneth Bilchick, professor of cardiovascular medicine and a clinical investigator at UVA. “The signal for benefit with colchicine in these patients was very impressive, and I expect that these findings will have quite a significant impact on clinical care in heart failure and future research for patients with this condition.”

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Plucking out the root cause

It may be years before colchicine is cleared for use in heart failure. Until then, the best thing you can do for your heart and overall health is to take steps to block chronic inflammation.

For instance, exercise has been shown to act as a sort of sentry that blocks a pro-inflammatory molecule, keeping damaging chronic inflammation at bay. You don’t even need to go hardcore; just taking a walk, doing household chores or working in your garden can help lower inflammation levels.

A clean, healthy diet is absolutely key to fighting chronic inflammation. If you eat a lot of fat and cholesterol, refined flour and sugar, beverages containing caffeine (however, with both gout and heart failure, coffee has shown beneficial) and alcohol, nightshades and allergens like nuts, it can spark chronic inflammation that can damage your heart health over the long term.

Instead, try to avoid processed foods that are often acidic to the body and eat more alkalizing foods like fruits, vegetables and whole grains. A regimen like the green Mediterranean diet includes all of those healthy foods.

Also, make sure you’re getting plenty of anti-inflammatory nutrients like omega-3 fatty acids and vitamins A, C, D3 and E. You can get these nutrients from foods like fruits, vegetables and fish, but supplements can help boost your levels quickly if you’re deficient in any of them. For example, vitamin D deficiency is common among Americans, so it may be wise to take a good quality vitamin D3 supplement daily.

Finally, there are other supplements that can help tame chronic inflammation, including turmeric, ginger and black cumin seed oil. Adding one (or all) of these to your daily regimen will give you an added boost of inflammatory-fighting power.

Sources:

Gout Medicine Improves Survival for Heart Failure Patients, Study Finds — UVA Health

Association of colchicine use for acute gout with clinical outcomes in acute decompensated heart failure — Clinical Cardiology