Clinical guideline developers: Association of Pediatric Cardiologists of Russia, Russian Medical Society for Arterial Hypertension
Coding according to the International Statistical Classification of Diseases and Related Health Problems: ICD-10: I10/ I11/ I12/ I13/ I15/ P29.2
Age group: Children
Year of approval: 2025

Relevance. The increasing prevalence of gout among patients with hypertension and other cardio-vascular diseases, as well as harmful influence on cardio- vascular risk warrant the need for more scrupulous examination and multidisciplinary approach to hypertensive patients with gout.
Aim. To identify clinical features of comorbid patients with hypertension and gout, as well as to assess their treatment.
Materials and methods. 57396 ambulatory patients from the national registry of hypertension were included in this study. They were divided into 2 groups based on the presence of gout. The assessment of social and anthropometric factors, medical history, modifiable cardio-vascular risk factors was conducted. Statistical analysis was done using R 4.3.3 environment (R Foundation for Statistical Computing, Vienna, Austria).
Results. 0,6% of hypertensive patients had gout. Patients with gout more frequently had chronic heart failure (63,9%), ischemic heart disease (52,5%), chronic kidney disease (39,8%), transient ischemic attack (3,1%). The majority of patients were men (65,1%) with such risk factors as obesity (52,5%), smoking (71,8%), alcohol intake (47,3%), sedentary lifestyle (37,8%) and poor diet (48,9%). They were also more frequently diagnosed with diabetes mellitus – 26,2% and liver cirrhosis (1,5%). The specific treatment features of this group of patients include more frequent therapy with angiotensin receptor blockers (30,9%) and loop diuretics – 13,6%.
Conclusion. Despite relatively low prevalence of gout in general population of patients with hypertension, this comorbid group of patients has high cardio- vascular risk and is characterised by exceptionally high presence of additional cardiac and non-cardiac pathologies. Distinctive features of treatment reflect the necessity of adaptive approach in order to meet the additional needs of these patients, including treatment of chronic heart failure and chronic kidney disease. Results of this study emphasise the necessity to implement a multidisciplinary approach in management of these patients, involving the aggressive modification of any risk factors and selection of a rational pharmacological treatment, based on concomitant pathology.

The article is devoted to one of the most controversial issues in the treatment of uncomplicated arterial hypertension (AH) – the role of beta-blockers (BB). For a long time, BB were not recommended as a first-line drugs for uncomplicated AH management. The most important role BB have in case of treatment of the uncomplicated AH with an increased heart rate (HR > 80’). Despite the lack of strict evidence for the BB efficacy in patients with uncomplicated AH and an increased HR, experts are increasingly confident in the advisability of this drug class using. In this regard, the reporting on the latest domestic and foreign recommendations of the BB need to be used in various clinical situations, including uncomplicated AH and high HR, is a very important event. In fact, these recommendations return BB to the list of main classes of antihypertensive drugs in uncomplicated AH management.
It was also noted that preference should be given to selective BB to increase therapy safety and reduce the risk of adverse metabolic effects.