You already know your risk of heart attack increases if you smoke or have a family history of heart disease – the top two risk factors. But do you know the next highest risk factor for men? It’s gout. 

Heart attacks are associated with the condition, according to a 2006 study in the journal Arthritis & Rheumatism, which found that gout and gout medications upped a man’s overall risk of heart attack by 26 percent after taking into consideration other known risk factors, including obesity, diabetes and high blood pressure.

“Some doctors used to think gout was just a pain issue and treated attacks with nonsteroidal anti-inflammatory drugs (NSAIDs), but when you now consider the effect of both NSAIDs and gout on the heart, we may be hurting patients more than helping them,” says lead study author Eswar Krishnan, MD, a rheumatologist at the University of Pittsburgh in Pennsylvania. NSAIDs have been linked to an increased risk of heart attack in susceptible people.

The best treatment for gout – which occurs when uric acid builds up in the body – is to control it and prevent attacks with gout medications that either lower the amount of uric acid produced or increase the amount of uric acid excreted. 

As it stands, allopurinol (Zyloprim) is considered the gold standard, but many people can’t take it because of allergies, kidney problems, high blood pressure, diabetes or heart disease. For them, the uric acid–lowering drug, febuxostat (Uloric), may be a better choice. Pegloticase (Krystexxa) is designed to treat ongoing gout by managing uric acid, not to treat an acute gout attack.

You are not out of options if you are a high-risk man suffering from gout; heart attack risk can be lowered by moderating the use of NSAIDs, says Dr. Krishnan. Oral colchicine is one type of gout medication that can be used to relieve acute pain and inflammation.