{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T23:27:42Z","timestamp":1788218862126,"version":"build-2803163510"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2017,7,4]],"date-time":"2017-07-04T00:00:00Z","timestamp":1499126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["M01 RR-00080"],"award-info":[{"award-number":["M01 RR-00080"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["M01 RR-00071"],"award-info":[{"award-number":["M01 RR-00071"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["M0100032"],"award-info":[{"award-number":["M0100032"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P20-RR11145"],"award-info":[{"award-number":["P20-RR11145"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["M01 RR00827"],"award-info":[{"award-number":["M01 RR00827"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["M01 RR00052"],"award-info":[{"award-number":["M01 RR00052"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["2P20 RR11104"],"award-info":[{"award-number":["2P20 RR11104"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["RR029887"],"award-info":[{"award-number":["RR029887"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["DK 2818-02"],"award-info":[{"award-number":["DK 2818-02"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000096","name":"National Center on Minority Health and Health Disparities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000096","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>There is little evidence guiding selection of nondiuretic, antihypertensive agents with a goal of lowering uric acid (SUA) and minimizing gout risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>In the African American Study of Kidney Disease and Hypertension (AASK) trial, African Americans with chronic kidney disease were randomly assigned to metoprolol (a beta-blocker), ramipril (an angiotensin-converting enzyme inhibitors [ACEi]), or amlodipine (a dihydropyridine calcium-channel blocker). SUA was measured at baseline and 12 months. Gout-related hospitalizations were based on ICD9 codes. Gout-related medication use (GRMs) was based on active prescriptions of allopurinol, colchicine, or probenecid during the baseline visit of the AASK cohort phase. We examined the effect of drug assignment on 12-month SUA (linear regression), gout-related hospitalization (Cox regression), and GRM (logistic regression).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Of the 630 participants, 40% were female with a mean age of 55 years (SD, 10), mean SUA of 8.2 mg\/dl (2.0), and mean serum creatinine of 1.8 mg\/dl (0.6). After 12 months, metoprolol increased SUA by 0.3 mg\/dl, while ramipril or amlodipine had no effect on SUA. Compared to ramipril, metoprolol significantly increased 12-month SUA (0.40; 0.10, 0.70 mg\/dl; P = 0.009), nonsignificantly increased risk of gout-related hospitalization (hazard ratio: 3.87; 0.82, 18.26; P = 0.09), and significantly increased the odds of GRM (odds ratio: 1.62; 1.03, 2.54; P = 0.04). While metoprolol was associated with a higher 12-month SUA compared with amlodipine (0.57; 0.18, 0.95; P = 0.004), there was no difference in gout-related hospitalizations or GRM.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Metoprolol increased SUA and GRM in African American adults. Health professionals treating patients with kidney disease at risk for gout should avoid metoprolol and possibly consider an ACEi.<\/jats:p><\/jats:sec><jats:sec><jats:title>CLINICAL TRIALS REGISTRATION<\/jats:title><jats:p>Trial Number NCT00582777.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ajh\/hpx113","type":"journal-article","created":{"date-parts":[[2017,6,13]],"date-time":"2017-06-13T19:10:04Z","timestamp":1497381004000},"page":"871-875","source":"Crossref","is-referenced-by-count":23,"title":["Metoprolol Increases Uric Acid and Risk of Gout in African Americans With Chronic Kidney Disease Attributed to Hypertension"],"prefix":"10.1093","volume":"30","author":[{"given":"Stephen P","family":"Juraschek","sequence":"first","affiliation":[{"name":"The Johns Hopkins University School of Medicine, Division of General Internal Medicine, The Johns Hopkins Bloomberg School of Public Health, and The Welch Center for Prevention, Epidemiology and Clinical Research 1 , Baltimore, Maryand , USA ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence J","family":"Appel","sequence":"additional","affiliation":[{"name":"The Johns Hopkins University School of Medicine, Division of General Internal Medicine, The Johns Hopkins Bloomberg School of Public Health, and The Welch Center for Prevention, Epidemiology and Clinical Research 1 , Baltimore, Maryand , USA ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Edgar R","family":"Miller","sequence":"additional","affiliation":[{"name":"The Johns Hopkins University School of Medicine, Division of General Internal Medicine, The Johns Hopkins Bloomberg School of Public Health, and The Welch Center for Prevention, Epidemiology and Clinical Research 1 , Baltimore, Maryand , USA ."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,7,4]]},"reference":[{"key":"2022111818052553200_CIT0001","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1002\/acr.22469","article-title":"Gout, urate-lowering therapy, and uric acid levels among adults in the United States","volume":"67","author":"Juraschek","year":"2015","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2022111818052553200_CIT0002","doi-asserted-by":"crossref","first-page":"e56546","DOI":"10.1371\/journal.pone.0056546","article-title":"Dose-response association of uncontrolled blood pressure and cardiovascular disease risk factors with hyperuricemia and gout","volume":"8","author":"Juraschek","year":"2013","journal-title":"PLoS One"},{"key":"2022111818052553200_CIT0003","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.semarthrit.2012.09.009","article-title":"Association of kidney disease with prevalent gout in the United States in 1988-1994 and 2007-2010","volume":"42","author":"Juraschek","year":"2013","journal-title":"Semin Arthritis Rheum"},{"key":"2022111818052553200_CIT0004","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1136\/ard.2006.055269","article-title":"EULAR evidence based recommendations for gout. 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