Abstract:
Introduction: Stroke remains a global burden. In New Zealand, it remains the third leading cause of death. The goal of treatment was suggested to be focused on prevention, targeting the cardiovascular risk factors including gout and serum urate believed to be also contributing to the occurrence and progression of cardiovascular diseases, including stroke. In New Zealand, one of the countries with the highest prevalence of gout worldwide, it was shown that gout co-exists with cardiovascular diseases. Aim: The aim of this study is to determine the prevalence of gout and hyperuricaemia, and the association of gout with serum urate, ethnicity, stroke type, hypertension, and diabetes mellitus; among stroke survivors in South and East Auckland. Methods: The data collected from review of electronic hospital discharge summaries and diagnostic results from brain imaging and serum urate test of randomly selected 500 eligible patients were analysed using SPSS version 23 to determine the crude prevalence of gout and hyperuricaemia among stroke survivors between the years 2010-2014. Multivariate logistic regression modelling was conducted to determine the association of gout with serum urate levels; ethnicity; gender; stroke type; and stroke risk factors, hypertension and diabetes mellitus. Findings: The crude prevalence of gout and hyperuricaemia among stroke survivors was 17% and 30%, respectively. Māori stroke survivors had the highest odds of developing gout [age- and gender-adjusted odds ratio (OR) 4.75 (CI 2.61,8.67), compared to non-Māori; 8.71 (4.10,18.53), compared to Europeans; and 2.23 (1.18,4.21), compared to Pacific Islanders]. Pacific Islander stroke survivors had age- and gender-adjusted OR of 1.93 (1.16, 3.24), compared to non-Pacific Islanders; and 3.9 (2.03,7.54), compared to Europeans. The age-, gender-, and ethnicity- adjusted OR for developing hypertension and diabetes mellitus among stroke survivors with gout history were: 3.25 (1.32, 8.03) and 1.94 (1.12, 3.36), respectively. There was no statistically significant relationship between gout and stroke type at p<0.05 (0.60, 2.55). Conclusion: There was a high prevalence of gout and hyperuricaemia among stroke survivors in New Zealand, with the highest prevalence among Māori. Stroke patients with gout history were shown to have a higher risk of developing hypertension and diabetes mellitus.
