You are what you eat! Too much of the wrong foods sets you up for health complications like hypertension and gouty arthritis. There’s the short answer. You knew this already. Right?
Now you want more facts? OK. About three out of four people with gout have high blood pressure. Another study showed participants with increased uric acid levels were more vulnerable to hypertension. Good enough for you?
If you really want to know more, this article will dive into how hypertension develops and how it sets you up for gout.
High Blood Pressure is Hypertension
If you have gout, then you’ve been to the doctor enough to know what blood pressure is and how its measured. If you don’t, click this link for the explanation from The American Heart Association.
According to the American Society of Hypertension guidelines, blood pressure categories are:
- Normal: lower than 120/80 (mm Hg)
- Pre-hypertension: 120/80 to 139/89 (mm Hg)
- Hypertension: above 140/90 (mm Hg)
For clarification, many people misconstrue muscle or mental stress, as hypertension. They are not the same. Stress can cause a temporary spike in blood pressure, via blood vessels constricting, but it will eventually return to a normal. The unhealthy reactions to stress like smoking, drinking alcohol and overeating is what raises blood pressure.
Hypertension is synonymous with high blood pressure (HBP). Stress can raise blood pressure temporarily. Unhealthy habits when reacting to stress will cause high blood pressure.
[For more details on sneaky gout triggers, read: The Absolute Worst Foods For Chronic Gout Sufferers]
Hypertension Causes Major Complications
Regularly monitoring your blood pressure is quite important and yet overlooked. Hypertension does not usually show obvious or early symptoms. That is why it known as the “silent killer”. Your blood pressure can quickly rise and remain high without you knowing it until a major health issue happens.
Over time, unmanaged high blood pressure can cause serious complications: heart attack/failure, stroke, aneurysm, chronic kidney disease, eye damage, and clogged arteries.
Hypertension sets up disorders of lesser degree such as fatigue, dizziness, blurred vision, irregular heartbeat, difficulty breathing and gout symptoms.
The link between gout and hyperuricemia are often overlooked even when 74% of chronic gout sufferers have high blood pressure. If you have hypertension, make sure to ask your doctor to test for your uric acid levels as well.
Here is a fantastic video illustrating high blood pressure, atherosclerosis and plaque.
Cholesterol and Purines
The cholesterol in our bodies come from foods with high saturated fat, trans fat, and dietary cholesterol. Over time, a diet consisting of foods with high cholesterol and purines can cause hypertension and gout.
Saturated fat is a major culprit in plaque buildup in the arteries. Animal meats are primary source of saturated fats. Certain oils are high in saturated fat too.
Some foods with high saturated fats: whole milk/cream, butter, high-fat cheese, high-fat meat (marbled beef, pork), hamburgers, processed/cured meats (cold cuts, bacon), whipped cream, palm oil, coconut milk.
Animal-based foods are what gout sufferers need to be aware of because of the possible high purine content. Some cured or processed meats are likely to have high sodium, plus gout-causing additives like MSG (monosodium glutamate). Also, milk and dairy products can make it harder for uric acid to be removed by the kidneys.
[For more details on how dairy products can slow down uric acid removal, read: What and Why Alkalizing Foods Help with Your Gout]
Trans Fat is short for trans-unsaturated fatty acids or trans fatty acids. This type of fat raises your low-density lipoprotein (LDL) or bad cholesterol levels, and lowers your good (HDL) cholesterol levels. Trans fat is a man-made fat. It is found in foods with partially hydrogenated oil. Note, some restaurants and food franchises tend to use more products with trans fat because it enhances taste and increases shelf life.
Some foods with high trans fat: fried foods, fast foods, fried snacks (chips), frozen dinners (pizza), margarine (shortening), doughnuts, non-dairy coffee creamers, cookies, packaged baked goods and many more.
For foods high in trans fat, meats used in fast food and frozen dinners may contain purines. How much, no one really knows!
Dietary Cholesterol is the actual cholesterol in the food itself. However, it is not exactly the same as the cholesterol that make up plaque in your arteries. In fact, studies concluded dietary cholesterol has less effect on blood cholesterol levels than trans fat and saturated fat. Nevertheless, it provides little nutritional value.
Food sources containing dietary cholesterol: animal meats, organ meats, fish (sardines), shellfish, skin of poultry, and egg yolks.
Keep in mind, organ meats, sardines, shrimp have high dietary cholesterol and purines.
The Atherosclerosis, Hypertension, Gout Connection
Atherosclerosis is the buildup of plaque on and in artery walls. The result is poor circulation of blood and insufficient oxygen supply to parts of the body. Atherosclerosis is a major factor of hypertension, which makes your body more prone to gout.
Plaque comes from food byproducts such as cholesterol, fat, calcium and blood clotting agents. A high level of LDL (bad) cholesterol is an indicator of plaque build-up.
As seen in the above video, blood pressure increases because of blocked or hardened arteries, and thicker blood. There are a variety of food sources or substances that cause plaque buildup and atherosclerosis.
Iron Overload Increases Frequency of Gout
Iron aids in red blood cell production and blood clotting. The condition when there is an overload of iron in the body is called hemochromatosis. Consequently, hypertension is developed due to the blood becoming thicker and harder to pump.
Since the body cannot remove excess iron, the absorbed iron deposits accumulate in joints, liver, testicles, and heart. Over time, this can cause health conditions like arthritis, fatigue, diabetes, sexual dysfunction, heart disorders and cirrhosis of the liver.
Also, a 2018 New Zealand study confirmed high levels of ferritin and iron in the body increased uric acid levels and gout flare frequency. Keep in mind, ferritin is the main protein in which iron is stored.
According to the Mayo Clinic, most people don’t experience signs of iron overload until later in life. Is it just a coincidence that recurrent gout typically starts later in life too? The overload of iron is a possible underlying factor to hypertension and gout.
Furthermore, there are two types of iron. First, heme iron is found in animal-based foods like organ meats, red meats, oysters, mussels, clams, sardines and mackerel.
Secondly, non-heme iron is found in plant-based foods: dried fruits, beans, lentils, spinach, Swiss chard, quinoa, morels, mushrooms, sesame seeds, pumpkin seeds.
Notice that iron from animals meats are usually high in purines; organ meats, red meats, shellfish and certain fish. Whereas, iron from plants do not contain as much purines.
Alcohol Triggers Fat and Uric Acid Production
Alcohol consumption raises the levels of fat in the blood. As dietician once told me, “alcohol makes fat stick around”. Referring to how alcohol prevents your body from flushing out fats and helps fat cells stick to certain areas in the body. Additionally, the liver turns sugar from alcohol to fat.
Long-term heavy drinking and consistent binge drinking can lead to hypertension and affect the functions of many vital organs. Scientists found binge drinking increased the development of atherosclerosis, which can lead to a heart attack or stroke.
For people with gout, the brewer’s yeast used to make beer and alcoholic spirits is a huge gout trigger. The high concentration of purines in brewer’s yeast will certainly raise your uric acid level.
More than three alcohol drinks every day is heavy drinking. Binge drinking is having more than five drinks consecutively. At this consumption rate, I doubt anybody with gout can last a week without a flare up! If so, let me in on your secret.
Salt Raises Blood Pressure but Lowers Uric Acid
Eating too much salt strains and constricts artery walls which increases blood pressure. High amount of sodium or salt in the blood also causes more water retention. Therefore, the blood becomes thicker and more difficult to pump by the heart.
Over time, salt can also narrow and weaken arteries. Less blood and oxygen slows down the kidneys’ ability to remove water and flush out waste products like uric acid. The worse case scenario is developing chronic kidney disease.
Surprisingly, research tests have shown an increased intake of salt reduced uric acid slightly. Furthermore, the results indicated lowering salt intake raised subjects uric acid levels. Nevertheless, physicians do not recommend consuming more salt to lower uric acid. The small reduction of uric acid would not be worth the drastic boost of blood pressure from more sodium.
Sodium may not directly produce uric acid, but can worsen joint and muscle swelling. Additionally, a high salt diet may deplete the body of calcium, which can eventually lead to weaker bones or osteoporosis. These two conditions can make arthritis and gout symptoms worse.
Products high in sodium may also be gout triggers; fast foods, frozen dinners, pickled foods, canned foods, cured-deli meats, sauces dressings and several others. Check food labels for sodium content whenever possible. More than 400 mg per serving is high in sodium.
Be aware of verbiage like “meat byproducts and variety meats”. These are possible gout triggers that may contain parts of high purine meats as well as additives like MSG and yeast extracts (a derivative of MSG).
Diuretics Lower Blood Pressure but Raise Uric Acid Level
Diuretics, or “water pills,” are medications that increase urination to remove salt and water in the body. They can treat mild hypertension because less salt and water lowers blood volume.
However, diuretics increase uric acid levels and the risk of gout. Excessive depletion of water, or dehydration, can leave a high concentration of toxins like uric acid in the blood.
Remember to stay well hydrated when taking diuretics. If you are on diuretics and experiencing more gout flares, it would be wise to discuss alternative medication with your doctor.
Kidneys Vital to Prevent Hypertension and Gout
The kidneys primary function is to remove waste substances from your blood. Over time, unchecked high blood pressure from a poor diet and lifestyle can cause arteries around the kidneys to weaken, narrow, and harden.
These damaged arteries prevent sufficient blood and oxygen to reach the kidneys. As a result, the weakened kidneys produce less aldosterone, a hormone that regulates blood pressure. Without proper treatment, the kidneys can begin to lose their ability to filter excess salt, water, fat, uric acid and other wastes.
In due time, these excess waste products build up in the body. For example excess fat in the blood forms cellulite in and around the body. Similarly, excess uric acid accumulates in joint(s) causing gout and tophus.
Weakened kidneys by poor diet sets up the body to be prone to hypertension and gout. Optimal kidney function is vital in removing unhealthy food byproducts including uric acid.
Different Conditions but Similar Diet Plan
The National Institute of Health created the DASH (Dietary Approaches to Stop Hypertension) eating plan to help lower blood pressure. Studies have shown it does lower blood pressure, LDL (bad) cholesterol and uric acid levels.
Does it help with gout? Yes. The DASH diet incorporates more fruits, vegetables, seeds, whole grains, low-fat/nonfat dairy and lean meats. The diet limits eating foods high in saturated fat, such as fatty meats, high-fat dairy products, and certain oils. Also, other recommendations include consuming less salt, sweets, sugar-sweetened beverages, and alcohol.
There’s nothing new to the DASH diet. It been around since 1992. However, it is a prudent starting point to improve your current crappy diet. Since the DASH diet recommends eating less gout-causing foods like meats, alcohol and high-fructose drinks, it is highly recommended to all gout sufferers.
When it comes to gout, the main issue is overeating those savory purine-rich foods like red meats and shellfish. For any diet, the biggest challenge is starting healthier habits like choosing more nutritional snacks and meals than unhealthy ones.
If you doubt 74% of people with gout also have high blood pressure, I’ve mentioned plenty of studies linking certain foods cause both hypertension and gout. Please consider hypertension as a legitimate marker to your diet and overall health. Poor dietary habits can bring about so many health issues sooner than expected.
The double whammy foods like organ meats (red meat, shellfish, sodium and alcohol), sets you up for hypertension and hyperuricemia. Foods high in fat turn into cholesterol then build up in arteries causing hypertension. Some of these foods contain purines which increases uric acid and the risk of gout.
Again, you are what you eat. It does not mean to deprive yourself of the foods you love. It does mean to start being aware of eating more nutritional food and less junk food. So, eat healthier! It is easier said than done. I know! However, it can be done with one small improvement every day or week.
High blood pressure is a warning sign that can lead to many health complications. Since hypertension can develop at a much younger age than gout, it would be wise to monitor it as early as possible. Getting your blood pressure under control is a great benchmark in becoming GOUTPROOF!