ResultsWe identified 87 patients in group 1 and 140 patients in group 2. Group 3 included 100 patientsrandomly chosen from the 7216 patients with a first diagnosis at age over 40 years. Patients withingroup 1 had significantly higher serum uric acid (sUA) levels at the time of diagnosis and a moreprominent family history of gout. Younger patients (groups 1 and 2) had a significantly higher bodymass index than patients over 40 years of age (group 3). A substantial number of younger patients alsohad hypertension or hyperlipidemia. The majority of younger patients met the 2012 American Collegeof Rheumatology (ACR) guidelines for initiating urate‐lowering therapy (ULT) on the basis offrequency of gout attacks, whereas the majority of patients over 40 years of age met the guidelines forULT on the basis of chronic kidney disease. Patients over 40 years of age were more likely to achievean sUA level less than 6.0 mg/dl.