Page "Gout" Paragraph 13

The triggers for precipitation of uric acid are not well understood.

While it may crystallize at normal levels, it is more likely to do so as levels increase.

Other factors believed important in triggering an acute episode of arthritis include cool temperatures, rapid changes in uric acid levels, acidosis, articular hydration, and extracellular matrix proteins, such as proteoglycans, collagens, and chondroitin sulfate.

The increased precipitation at low temperatures partly explains why the joints in the feet are most commonly affected.

Rapid changes in uric acid may occur due to a number of factors, including trauma, surgery, chemotherapy, diuretics, and stopping or starting allopurinol.

Calcium channel blockers and losartan are associated with a lower risk of gout as compared to other medications for hypertension.