One in three Americans has high blood pressure.

That’s bad enough, but treatment efforts may have an unintended consequence that’s a real pain… in the big toe.

Drugs called diuretics can lower blood pressure by flushing water and sodium from the body.

But these medications may increase the risk of gout, a form of arthritis that’s most common among overweight, middle-aged men.

Caused by excess uric acid in the bloodstream, gout is a chronic disease characterized by episodes of joint pain that can last for days. It most often strikes the big toe, but other joints in the arms and legs can be affected.

A study published recently in The Journal of Rheumatology is the first to investigate how much influence diuretics have on gout flare-ups.

Researchers with Boston University used Internet advertisements to recruit about two-hundred self-described gout sufferers from around the United States.

These volunteers were asked to keep track of their gout attacks for one year, and also note any use of diuretics.

The results showed fifty-six volunteers took diuretics at least once during the study. By analyzing the data from this subgroup, researchers found the risk of gout attack more than tripled for forty-eight hours after the use of diuretics.

The researchers also pointed out that other medications reduce blood pressure without promoting gout.

Individualized treatment sounds like the best approach. Blood-pressure management is serious business, and keeping gout out of the picture could help patients stay on track.