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Disease of kings

A wealthy affliction


ILL & ELITE: Benjamin Franklin (left) and Queen Victoria suffered from gout, a type of arthritis caused by build up of uric acid in the blood

Gout, 'disease of kings', is on the way back. Obesity and heavy drinking is being blamed for the increase in numbers.

Gout, once the "king of diseases and the disease of kings", is making a painful resurgence. Hospital admissions for the condition, which has afflicted sufferers from Alexander the Great to Leonardo da Vinci, and Queen Victoria to Laurence Olivier, have almost doubled in a decade. New research shows that admissions are increasing at around 7 per cent a year, with more than 4, 000 people seeking treatment each year, many of them as emergencies.

A new study, reported in the journal Rheumatology, revealed there were 32, 741 hospital admissions of gout sufferers in England - a 7. 2 per cent annual increase - between 1999 and 2009. Emergency admissions increased 86 per cent from 1, 875 to 3, 496. The study also showed a smaller, but still substantial increase in gout sufferers in New Zealand.

"We have shown that hospital admissions for gout are increasing significantly over time, " said Dr Philip Robinson of the University of Queensland, who led the study - one of the world's largest.

"We are seeing this trend in all countries that have reported figures. Why is gout increasing? The prevalence of obesity is increasing worldwide due to people taking in too many calories and not exercising. "

The results also revealed that gout sufferers tended to have other health problems, including high blood pressure (39 per cent), diabetes (20 per cent) and cardiovascular disease (39 per cent).

Gout is a type of arthritis caused by a build-up of uric acid in the blood after the kidneys fail to deal with it. This results in needle-shaped crystals, which form in and around joints, particularly the big toe, causing severe pain.

Historically, the disease was linked almost exclusively to wealthy people, who could afford the luxury of a fine lifestyle. Famous members of the gout sufferers' club include Henry VIII, Isaac Newton, the poet Alfred Lord Tennyson and the US founding fathers Thomas Jefferson and Benjamin Franklin. Nowadays, though, the disease is no longer the preserve of the rich, with an estimated one in 70 adults in the UK suffering from symptoms.

A number of risk factors for the condition have been identified, including alcohol, diet, obesity, high cholesterol and hypertension, all of which increase uric acid levels.

Alcoholic drinks raise the level of uric acid in the blood by increasing its production in the liver, and by reducing how much is passed out in urine. Beer is known to be a particular problem.

Professor Anthony Jones, who specialises in neurorheumatology at Manchester University, said: "The figures are interesting, and it is a huge study. Essentially, gout is increasing because of bad habits. We drink too much, eat the wrong food, do little exercise and are overweight. I can remember only a small number of gout patients who were thin. People tend to associate heavy drinking with young people but, in fact, older people consume more, and gout is a disease of older people. "

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