Gout is known to be more prevalent in men. To be even more specific, African Americans are at higher risk for gout, twice compared to European Americans. Previously, little was known about gout’s prevalence in this population group. This is because African Americans are an underserved and understudied group. However, recent studies have shed light on how much they are at risk for gout.
Gout flares are due to the accumulation of uric acid in the body. Hyperuricemia is the term used to define high uric acid levels. One is considered to have hyperuricemia when they have uric acids greater than 7.0 mg/dL (men) and 5.7 mg/dL (women).
When you have gout, you’re also likely to be obese, diabetic, have high blood pressure, and metabolic syndrome. If you haven’t been diagnosed with gout, but you have these conditions, you probably have hyperuricemia. In this case, you need to take the right steps to lower your uric acid, so you don’t develop gout.
African Americans with Gout
In this article, we’ll investigate the factors that lead to African Americans patients experiencing gout. It cannot be stemmed from one reason alone but a combination of factors.
In one study, they found that African Americans had a significantly higher baseline history for conditions such as diabetes, renal impairment, and cardiovascular disease compared to Caucasians. These are all comorbidities related to gout.
In 2002, the National Ambulatory Medical Care Survey analyzed 3.9 million patients with gout and found out that African Americans were less likely to receive uric acid lowering therapy compared to Caucasians. In fact, only 10% of those who opted were African Americans while 82% were Caucasians. African American patients were also less likely to be adherent with the therapies required to lower their uric acid.
The perception of gout can also affect how well one adheres to gout therapies. One study shows that compared with Caucasians, African American patients were more likely to be affected by the impact gout has on their quality of life. They had higher concerns regarding dietary restrictions, interruptions to their daily life, their emotional health, and the need to use a cane or crutch during a gout attack.
A more recent study published August 2022 at JAMA Network Open that black adults are more likely to develop gout compared to their white counterparts. Black women had significant 81% higher risk of developing gout compared with white women and black men had 26% higher risk for gout compared with white men.
To be specific, these were the common complaints raised by African American patients when it came to gout:
● Gout impacted their social life not being able to do things like go out to dinner, church, movies, etc. They also weren’t able to perform recreational activities like biking, playing music, running, etc.
● Gout medications were not ideal to take together with other medications used for high blood pressure or diabetes. They also found it inconvenient to take gout medication everyday.
● Dietary restrictions for gout were too confusing and restricting. There’s too much conflicting information on the internet and it’s hard to notice what foods triggered the attack. It also removed foods that they used to enjoy such as red meat, seafood, alcohol, etc.
● Gout attacks were extremely painful and made patients emotional and mean during flares. Even the slightest touch would cause a lot of pain.
● Gout attacks were unpredictable and would bring a whole day to a halt.
● Gout caused them to miss days at work and probably strained their relationship with management.
● Gout affected one’s self-esteem. Young gout patients feel like they have lost their youth for having the condition. It also increased their dependency on others not being able to do basic things such as getting out of bed, preparing their own meals, going to the bathroom, etc.
● Gout limited sexual activity and impacted their relationship with their partner.
● Gout impacted their sleep. They either had disrupted sleep due to a gout attack or had a hard time falling asleep.
The study shed light on the concerns that African Americans have regarding gout. This helps to build up the existing knowledge we have of gout. Things such as lack of sexual function, employability, sleep, hobbies, and relationships were aspects that were previously not reported.
They are considered an understudied group and so knowing how it impacts them helps the medical industry to give better insight on gout. Patients need to be educated about gout as a condition, its treatments, and potential risks for not adhering to treatments.
The study suggests that a pessimistic view of gout can negatively affect how patients manage their condition, not taking their medication as prescribed by the doctor or proactively trying out therapies that can help minimize symptoms.
Gout is not necessarily the end of one’s youth or vitality. It is but a very manageable condition. With the right mindset and habits, symptoms can be controlled. Even more so, it can lead patients to a healthier life. All these factors combined make African Americans more likely to experience gout.
High Risk, Low Prevalence
Despite their high risk factors for gout, it’s been found that African Americans have lower prevalence for gout. What does this mean? It means that even if a patient has all the risk factors for gout, they may not necessarily develop the condition.
In the United States, African Americans possess habits and conditions that should make them more likely to develop gout. They have higher frequency of seafood consumption and alcohol, physical inactivity, obesity, elevated blood levels, hypertension, diabetes, and renal failure.
Despite that, they don’t necessarily develop gout later on compared to Caucasians whose incidences are much higher. Researchers suggest that it could be a biological factor in African ancestry that makes them less likely to develop gout. This is further supported by surveys in African countries including Congo, Ethiopia, Kenya, Rwanda, South Africa, Togo, Zaire, and Zimbabwe which all show extremely low incidences of gout.
African Americans and Gout Medication
When it comes to gout medications, African Americans need to pay special attention to what they take. A study shows that both black and asians have higher risk for complications from taking gout medication, allopurinol.
Compared with Caucasians, African American patients who took allopurinol were five times at more risk for Stevens-Johnson syndrome and toxic epidermal necrolysis. These skin reactions are potentially deadly. It begins with flu-like symptoms, followed by large portions of rashes in the skin. Having this condition can make the patient at more risk for infections.
Health professionals should be aware of this risk and consider other gout medication options such as febuxostat, probenecid, and lesinurad.
Hip-Hop Culture Veganism: African American’s Answer to Remedying Gout
We may expect to see even lesser prevalence of gout in African Americans. This is due to the growing number of vegans in this demographic. A 2016 study by the Pew Research Center shows that African Americans are the fastest growing demographic for vegans in the United States.
Black pop culture could be the cause for this movement. Several hip-hop artists such as Jay-Z, Beyonce, Cardi B, and members of the Wu-Tang Clan all advocate for veganism, and we’re not just talking diet but also business decisions.
Here are some examples of African American pop culture figures making a move towards vegan-friendly lifestyle choices.
● Sitc.man had gout as his wake-up call but it helped him move towards the vegan lifestyle. Today, he has a fitness club with his wife where they run programs that promote veganism.
● Son of Will and Jada Smith opened a vegan food truck to feed the homeless.
● Jay-Z and Beyonce offered to give out free tickets to foods who would go vegan.
● Cardi B recently started a vegan fashion line.
● A$AP Rocky released a single about veganism called “Babushka Boi”.
● Beyond Meat has Snoop Dogg as one of their ambassadors.
● Artists Jermaine Dupri, Badu, Andre 3000, YG, DJ Khaled, Waka Flocka Flame are advocates for the plant-based diet.
Hip hop has a very huge influence on the black community and what is currently being promoted in their culture today will be heavily followed by the youth in this population.
Veganism is not just about living a healthy plant-based lifestyle. It can also serve as a solution for low-income black communities whose quality of life and access to food is impacted by the status. If vegan becomes more mainstream, urban centers may be more likely to provide it as an option to its recipients.
African American patients can help fight gout symptoms by going vegan. However, if that is unattainable, following the gout diet can be a good start. This means eating mostly clean carbohydrates from fruits and vegetables and limiting fat and protein to healthy sources such as lean meat and fish, nuts, seeds, and olive oil.
In addition, gout can be managed by a number of remedies such as physical exercise, drinking lots of water, taking cherry supplements, doing Epsom salt baths, making the body alkaline, etc.
It’s also important to know that gout impacts race and genders differently. In this article, we learned that African Americans are not genetically predisposed to gout but the most common conditions they have fit that of a person that should be at high risk for developing gout.
What makes them at more risk for worsening gout symptoms is their views of the condition. Their adherence to treatment is highly affected due to pessimistic views on gout and its impact on their quality of life.
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