Do diuretics taken to control high blood pressure sometimes cause gout?

Answers from April Chang-Miller, M.D.

Yes. Diuretics can increase your risk of developing gout, a type of arthritis caused by the buildup of uric acid crystals in a joint.

This may happen because diuretics increase urination, which reduces the amount of fluid in your body. But the remaining fluid is more concentrated, which can increase the risk that you'll develop the crystals that cause gout. Some types of diuretics also reduce the kidneys' excretion of urate, a component of uric acid.

You and your doctor will decide if it's best for you to continue taking the diuretic, or switch to another medication. There are many other types of blood pressure medications that don't increase your risk of gout. Also, many of the measures you take to reduce blood pressure have the added benefit of lowering uric acid. Other measures that you can take to lower uric acid include:

  • Eating a healthy diet, with an emphasis on vegetables, plant proteins, low-fat dairy products and whole grains, and reduced servings of meat and seafood
  • Drinking little to no alcohol
  • Limiting beverages that are sugar sweetened and limiting foods and beverages that contain high fructose corn syrup
  • Losing weight and maintaining a healthy weight based on your body mass index

To help manage gout, it's also important to stay hydrated by drinking plenty of water. You can also limit your intake of foods rich in the compound purine, which form uric acid when they are broken down. Common purine-rich foods include liver, mackerel, herring, game meats and sardines.

Sept. 16, 2017