Gout and Hyperuricemia Prevalence in the US

Zhu Y, Pandya BJ, Choi HK • Arthritis Rheum

Key Finding

Gout and hyperuricemia affect 8.3 and 43.3 million Americans respectively

Original title: “Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008”

Plain English Summary

NHANES analysis showing gout affects 8.3 million Americans and hyperuricemia affects 43.3 million. Prevalence has increased substantially since 1990.

In-Depth Analysis

Background

Zhu Y, Pandya BJ, Choi HK. Arthritis Rheum. 2011;63(10):3136-3141. PMID: 21800283

This NHANES analysis from Boston University School of Medicine established contemporary US prevalence estimates for gout and hyperuricemia, documenting the substantial disease burden and its metabolic associations.

Study Design

Parameter	Details
Design	Cross-sectional analysis of NHANES 2007-2008
Population	5,707 US adults representative sample
Definitions	Gout: self-reported physician diagnosis; Hyperuricemia: >7.0 mg/dL men, >5.7 mg/dL women
Analysis	Weighted prevalence estimates, subgroup analyses

Key Findings

Condition	Prevalence	Affected (millions)
Hyperuricemia	21.4%	43.3 million
Gout	3.9%	8.3 million

Risk Factor	Hyperuricemia Prevalence
Metabolic syndrome	62.8%
Obesity (BMI ≥30)	44.1%
Hypertension	47.2%
CKD Stage ≥2	53.4%

Mechanistic Insights

Hyperuricemia clusters with metabolic syndrome features because fructose metabolism, insulin resistance, and impaired renal urate excretion share common pathways. Elevated uric acid may be both consequence and contributor to metabolic dysfunction.

Clinical Implications

Over 1 in 5 US adults have hyperuricemia, far exceeding gout prevalence. This "asymptomatic" hyperuricemia is associated with cardiovascular and metabolic risk independent of gout development.

Metabolic Health Perspective

The 21% hyperuricemia prevalence validates the importance of uric acid assessment. The uric acid evaluator's optimal threshold (<5.0 mg/dL) identifies individuals well below the disease-defined cutoff but potentially at elevated metabolic risk.