April 20 of each year is World Gout Day, and the reason why this date is defined as Gout Day is because when the level of uric acid in the human blood exceeds 420μmol/L for many years, the problem of high uric acid appears, and the complications that accompany high uric acid are the problem of acute gout attacks. Therefore, April 20 Gout Day is to remind the majority of patients with high uric acid and gout that they must reasonably control the level of uric acid and reduce the risk of gout attacks.
With the continuous improvement of living standards, there are now more and more friends with high uric acid gout problems, especially among young and middle-aged men, the proportion of people with this problem is getting higher and higher, and it has become a common health problem that plagues many people.
Two-thirds of the uric acid in the human blood comes from the metabolism of its own cells, and the other part comes from the external ingestion of purine metabolism, therefore, the problem of high uric acid, in the final analysis, is that our body's metabolic function of uric acid is abnormal, the body's ability to decompose uric acid has decreased, and the level of uric acid elimination has also decreased, so the uric acid level will further increase.
Uric acid is a slightly soluble crystalline substance, when the urate level in the human blood exceeds 420μmol/L, uric acid will precipitate crystals in the near-neutral blood, and these urate crystals will eventually be deposited in the joints, kidneys and other parts in the process of blood circulation, under certain conditions, triggering acute inflammatory reactions in the joints, there will be symptoms such as joint redness and swelling, severe pain, etc., we call it "gout" If the problem of high uric acid is ignored, even if there is no gout, chronic urate deposition may form problems such as tophi and uric acid kidney stones, which will also cause great harm to health.
Therefore, if we want to reduce the risk of gout attacks, we must fundamentally control our uric acid levels, and the harm of high uric acid is not only the health impact on joints and kidneys, more and more relevant studies have found that high uric acid will also affect vascular health, increase the risk of cardiovascular and cerebrovascular diseases, and has become the "fourth highest" in cardiovascular health in addition to hypertension, hyperlipidemia and diabetes.
More often, patients with high uric acid often have comorbidities such as hypertension, dyslipidemia, diabetes, etc., which actually reflect the abnormality of human metabolism, and for patients with high uric acid with three high comorbidities, it is a very particular thing to choose antihypertensive drugs, lipid-lowering drugs, and hypoglycemic drugs. If you can choose drugs that can control the three highs and chronic diseases, and at the same time have the effect of reducing uric acid, of course, it is very ideal, today's popular science, to introduce you to three common drugs that can reduce the three highs and reduce uric acid.
Losartan
Losartan is the earliest angiotensin 2 receptor antagonist drug on the market, is a representative drug of sartan drugs, in terms of blood pressure, its antihypertensive strength is not much different from most of the sartan drugs, like other sartan antihypertensive drugs, it also has the additional benefits of improving microproteinuria, preventing myocardial hypertrophy, etc., but compared with other sartan antihypertensive drugs, losartan has a "unique skill" - uric acid-lowering effect.
Due to the differences in chemical structure, losartan can not only inhibit vascular tension and reduce blood pressure, but also inhibit the reabsorption of uric acid by the kidneys, thereby promoting uric acid excretion and reducing blood uric acid. Research data show that the average decrease in blood uric acid level in hypertensive patients taking losartan potassium can reach about 7%~15%, although this uric acid lowering amplitude is not as strong as special uric acid-lowering drugs such as febuxostat, but for patients with high blood pressure and high uric acid, it is also a very friendly antihypertensive drug.
In the process of taking losartan potassium, it is necessary to pay attention to the possible adverse reactions such as angioneurotic edema and hyperkalemia, but it is usually well tolerated and the incidence of adverse reactions is also very low.
Atorvastatin
Atorvastatin is one of the most commonly used lipid-lowering drugs in clinical practice, and it is also a first-line lipid-lowering drug that has been widely used, it has a long-term effect, flexible taking time, high lipid-lowering intensity, and is widely used in the population, and is a very commonly used lipid-lowering drug, taking medium and low doses of atorvastatin, it can reduce the level of low-density lipoprotein cholesterol by about 30% to 50%, in addition to lowering blood lipids, it also has the effect of delaying atherosclerosis and reducing the risk of cardiovascular disease.
In addition to lowering blood lipids and protecting the cardiovascular system, atorvastatin is also a lipid-lowering drug that can lower uric acid, from the mechanism of action, atorvastatin also promotes uric acid excretion by inhibiting the URAT1 of the kidneys to achieve the effect of lowering uric acid, from the effect of lowering uric acid, atorvastatin can reduce the level of uric acid by about 6~10%, for patients with hyperlipidemia with elevated uric acid edge, by taking atorvastatin, the uric acid level can be reduced to a reasonable level of 360μmol/L.
Precautions for taking atorvastatin include regular monitoring of liver function, creatine kinase levels should be checked in time if muscle pain occurs, and atorvastatin should be discontinued in time if the indication for discontinuation is met, atorvastatin may also affect blood glucose metabolism, but elevated blood glucose should not be used as a basis for discontinuation, patients with renal insufficiency, atorvastatin does not need to be reduced in dose, but atorvastatin should be contraindicated in patients with severe hepatic insufficiency.
Empagliflozin
Empagliflozin is a new type of hypoglycemic drug that reduces blood sugar by promoting the excretion of glucose in the urine, in addition to lowering blood sugar, this kind of drug can reduce blood sugar, as well as mild blood pressure, weight reduction and other additional benefits, for patients with chronic kidney disease, heart failure patients, such drugs are treatment drugs with clear indications, in addition to empagliflozin, dapagliflozin, canagliflozin and other drugs also belong to the same kind of drugs.
Clinical data show that the above three gliflozin drugs can reduce uric acid levels by an average of 37.7 μmol/L, of which empagliflozin has the most significant uric acid-lowering effect, which can reach 45.8 μmol/L, which can be said to be equivalent to the uric acid-lowering effect of atorvastatin.
The precautions for taking gliflozin hypoglycemic drugs are mainly to pay attention to the increased excretion of glucose in the urine, which may bring the risk of genitourinary infection, in addition, such drugs can also slightly reduce blood volume, therefore, during taking such drugs, you should pay attention to drinking more water and supplementing nutrition reasonably.