Gout and High Blood Pressure: What's the Connection?
A Clear, Evidence-Based Answer
Gout and high blood pressure often occur together, but one doesn't simply cause the other — they share underlying risk factors, and some blood pressure medicines can also affect uric acid levels.
Gout → blood pressure: commonly seen together, but the association doesn't prove one directly causes the other.
High blood pressure → gout: linked to higher gout risk, mainly through shared factors like kidney function and weight — not a simple direct switch.
Blood pressure medicines: some (especially diuretics) can raise uric acid; others (losartan, calcium-channel blockers) appear neutral or slightly lowering.
What to do: never stop or change prescribed medication because of this page. If you have recurrent gout and take blood pressure medicine, raise it with your GP or pharmacist.
Why Are Gout and High Blood Pressure Connected?
Gout and high blood pressure cluster together more often than chance alone would explain, mainly because they share underlying contributors rather than one simply causing the other.
Kidney function. Most uric acid is cleared by the kidneys. Reduced kidney function, more common as blood pressure rises over time, is one of the clearest routes to higher uric acid and, eventually, gout.
Weight and metabolism. Both conditions are strongly linked to excess weight and metabolic syndrome, including insulin resistance, which independently raises both blood pressure and uric acid.
Overlapping risk factors. The NHS lists high blood pressure, high cholesterol and diabetes together as gout risk factors, alongside lifestyle factors like alcohol and diet.
Medication effects. Certain blood pressure medicines can themselves influence uric acid — covered below.
Lowering your blood pressure won't automatically resolve gout, and lowering uric acid won't automatically treat high blood pressure — each needs its own proper management. See our full guide to what causes gout.
Can High Blood Pressure Cause Gout?
People with high blood pressure have higher rates of gout, and the NHS lists high blood pressure among the recognised risk factors. But association isn't the same as direct cause — much of the extra risk is likely explained by reduced kidney function, excess weight and blood pressure medicines, rather than raised blood pressure itself triggering crystal formation.
Plenty of people with high blood pressure never develop gout, and plenty of people with gout have normal blood pressure. See our guide to what causes gout for the full picture.
Can Gout Cause High Blood Pressure?
The evidence here is less clear-cut. Gout and raised uric acid are associated with hypertension, and researchers are investigating whether high uric acid itself affects blood vessels or kidney function over time — but this remains an active research question, not settled fact.
A single gout attack does not cause chronic high blood pressure, and there's no good evidence that treating gout alone reliably lowers blood pressure. The two conditions need managing on their own terms.
Blood Pressure Medicines and Gout
Different classes of blood pressure medicine have different, well-documented associations with uric acid and gout risk.
Diuretics
Thiazide diuretics (such as bendroflumethiazide) and loop diuretics (such as furosemide) are well established to raise serum uric acid, partly by reducing how much the kidneys excrete alongside excess salt and water. The NHS specifically names diuretics ("water tablets") among medicines linked to increased gout risk. This doesn't mean diuretics are wrong for you — they're prescribed because blood pressure control matters. Any change is a decision for your prescriber, not something to adjust yourself.
Other Blood-Pressure Medicines
A well-known population study (Choi et al., BMJ) found diuretics and beta-blockers associated with higher gout risk, while calcium-channel blockers and losartan (an angiotensin receptor blocker, or ARB) were associated with lower risk. The NHS also lists ACE inhibitors among medicines linked to increased gout risk. Losartan is unusual among ARBs, having a mild uric-acid-lowering effect other drugs in its class don't share.
This is population-level association evidence, not a personal prescription. It doesn't mean a particular drug is automatically right for you, or that your current medicine is wrong — that balance is for your prescriber to weigh up.
| Blood Pressure Medicine | Typical Association |
|---|---|
| Thiazide diuretics | Raises uric acid; increased risk |
| Loop diuretics | Raises uric acid; increased risk |
| Beta-blockers | Associated with increased risk |
| ACE inhibitors | Associated with increased risk (NHS) |
| Losartan (ARB) | Mild urate-lowering effect; lower risk |
| Other ARBs | Don't share losartan's urate effect |
| Calcium-channel blockers | Associated with lower risk |
Nobody should stop, reduce or switch prescribed blood pressure medication because of this page. Uncontrolled high blood pressure carries serious risks to the heart, kidneys and brain that generally far outweigh any effect a medicine may have on uric acid. If you have gout or recurrent flares and take a blood pressure medicine, mention it to your GP, prescriber or pharmacist at a routine review. Any medication change belongs with the clinician managing your care.
What If You Have Both Gout and High Blood Pressure?
- Make sure both conditions are actively managed, not treated as unrelated.
- Mention recurrent gout to whoever manages your blood pressure medication, and vice versa.
- Ask about a routine medication review if relevant — not to self-select a drug, but so your prescriber has the full picture.
- If gout keeps recurring, long-term control usually means uric acid-lowering therapy, prescribed and monitored by a doctor — see our full gout treatment guide.
- Keep taking blood pressure medication exactly as prescribed unless your doctor advises otherwise.
Lifestyle: What Helps Both Conditions
A few lifestyle factors genuinely support both blood pressure and uric acid: a healthy weight, limiting alcohol — especially beer and spirits, see alcohol and gout — staying well hydrated to support kidney function, see hydration and gout — and regular activity alongside a balanced diet, see our full diet guide. For broader day-to-day management, see living with gout. Check any significant diet or lifestyle change with your doctor if you're on medication or have other health conditions.
Is High Blood Pressure a Reason to Check Uric Acid?
Having high blood pressure alone isn't a reason for routine uric acid testing if you have no joint symptoms — there's no UK guidance recommending universal urate screening based on blood pressure. Testing becomes relevant with symptoms suggestive of gout, such as a sudden, hot, swollen joint, or to monitor levels once already on urate-lowering treatment. See our uric acid levels chart for what the numbers mean, and raise any joint symptoms with your GP.
Speak to your GP if you're having recurrent gout attacks, especially on blood pressure medication; if you're concerned a prescribed medicine might be contributing (raise it, don't stop it); if either condition feels hard to control; or if you think you might be having a first gout attack and want it properly diagnosed.
Seek urgent assessment if a joint is hot, very swollen and rapidly worsening, especially with fever or feeling unwell — these can signal joint infection rather than gout. In the UK, contact your GP for a same-day appointment, call NHS 111 out of hours, or go to A&E if you feel very unwell.
Gout and High Blood Pressure FAQs
Is gout linked to high blood pressure?
Yes. They occur together more often than chance alone explains, largely because they share risk factors like kidney function and weight, and because some blood pressure medicines affect uric acid.
Can high blood pressure cause gout?
It's associated with higher risk rather than a direct cause. Much of the extra risk likely comes from shared factors like kidney function and weight, not blood pressure itself.
Can gout raise blood pressure?
The evidence is less clear-cut. Gout and raised uric acid are associated with hypertension, but a single attack doesn't cause chronic high blood pressure — it's an active research area, not settled fact.
Can blood pressure tablets cause gout?
Some can. Diuretics, beta-blockers and ACE inhibitors are linked to raised uric acid and higher gout risk, while losartan and calcium-channel blockers are linked to lower risk. This isn't a reason to change your own medicine without advice.
Do diuretics increase uric acid?
Yes. Thiazide and loop diuretics are well established to raise serum uric acid, partly by reducing how much the kidneys excrete.
Which blood pressure medicines affect gout?
Diuretics, beta-blockers and ACE inhibitors are linked to increased risk; losartan and calcium-channel blockers to lower risk. The right medicine for you depends on much more than gout, so this is a discussion for your prescriber.
Should I stop a diuretic if I have gout?
No. Never stop or change a prescribed blood pressure medicine yourself. Discuss concerns with your GP or pharmacist, who can weigh it against the risks of uncontrolled blood pressure.
Can I have gout and hypertension at the same time?
Yes — a very common combination. Each is diagnosed and treated on its own merits, and it helps if your clinicians know you have both.
Related Reading
What Causes Gout?
The full set of risk factors behind gout, from genetics to diet to medicines.
Read guide →Uric Acid Levels Chart
What's normal, high and target for uric acid, and what the numbers mean.
Read guide →Living With Gout
Practical, day-to-day guidance for managing gout alongside everything else.
Read guide →