Gout is a common medical condition, especially in in older adults. It consists of episodes of painful inflammation in joints and is caused by an increased amount of uric acid in blood. Uric acid is a normal waste product found in your blood stream – but having too much uric acid in the blood can lead to a condition called hyperuricemia (high levels of uric acid in the blood). The build-up of uric acid can form needle-like crystals in a joint, usually the cooler joints such as in the big toe. These attacks result in sudden pain, tenderness, redness, warmth and swelling.

People who have gout are more likely to have heart disease, blocked arteries and frequently heart failure. Gout is also associated with a greater risk of kidney disease, diabetes, cancer and sleep apnea, likely due to a high level of chronic inflammation. Left untreated, gout can be serious, with new research showing that patients with gout have double the risk for heart attack or stroke.

In patients with chronic heart failure, an elevated blood concentration of uric acid on routine blood testing is often detected. Diuretics, which patients with heart failure usually require to reduce fluid retention, often increase uric acid levels and lead to gout. Chronic alcohol consumption and obesity also contribute to increased uric acid formation. Gout symptoms usually develop after many years of sustained hyperuricemia. Increased levels of uric acid in the body as well as a satisfactory response to treatment can be confirmed by simple blood tests.

Maintaining a healthy uric acid level is important to reduce risk for gout for patients with heart failure and your doctor will take routine uric acid blood test especially if you use diuretics or have had an episode of gout. Exercising, maintaining a healthy body weight and avoiding certain foods that can trigger gout are important for reducing risk. These foods and drinks are very rich in purines, which are essential organic compounds that are broken down to uric acid. These include beer; yeast, peas, beans, lentils, spinach, mushrooms; red meat, lamb and pork; organ meats such as liver, kidneys and sweetbreads; and seafood, especially shellfish like shrimp, lobster, anchovies and sardines.

Medications, such as allopurinol, are commonly used to reduce uric acid levels by inhibiting its biosynthesis in the body, thereby preventing gout attacks. Furthermore, taking allopurinol to lower uric acid levels may protect you from worsening of heart failure. It is important to take this medication as prescribed, on a long-term basis, and not to stop it without talking with the doctor. There are several other drugs for acute or chronic gout that your doctor may prescribe if necessary. Remember to avoid use of Non-Steroid Analgesia (NSAIDs).

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ESC Guidelines for Heart Failure

What patients need to know

This guide for patients from the European Society of Cardiology aims to provide an overview of the latest evidence-based recommendations for the diagnosis and treatment of heart failure.

In particular, it should help patients to understand the:

  • main types of heart failure
  • medicines used to treat heart failure
  • devices that may be appropriate
  • importance of rehabilitation
  • management by a multidisciplinary team
  • importance of self-care in managing your own condition

Learn more


A series of 9 simple, captivating animations explaining heart failure and its treatment.

These narrated animations explain how a healthy heart works, what happens to it in heart failure and how various treatments work to improve your health.


In this section you can watch, listen or read interviews with other people with heart failure and their caregivers.


and share your own views and experiences with other patients, families and caregivers.

heartfailurematters.org is a European Society of Cardiology website

The heartfailurematters.org website was developed under the direction of the Heart Failure Association of the European Society of Cardiology (ESC). The ESC is a world leader in the discovery and dissemination of best practices in cardiovascular medicine. Our members and decision-makers are healthcare professionals who volunteer their time and expertise to represent professionals in the field of cardiology in Europe and beyond.

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