i have been taking altace (2.5 mg) and indapamide (1.25 mg) daily to control high blood pressure for a number of years (at lease 15 - 20 years). In the last few years, I have started symptoms of gout attacking mostly my feet and toes and as blood uric acid levels have been consistantly high, last year in September, as a precautionary measure and to see if the levels and gout attacks would drop, indapamide was discontinued and altace was changed to ramipril and increased to 5 mg daily. During this last year i have not had any gout attacks, however, I have had swelling of my arms and legs, along with stiff muscles and sore knees (contained mostly on the right side of my body). a routine stress test along with the affiliated ecocardiagrams in September has revealed that i now have chronic high blood pressure, averaging 160/102 and an ecocardiagram has revealed a somewhat thickening and enlargement of the heart. I have now been prescribed Altace HCT (5 mg ramipril and 12.5 hydrochlorothiazide) tablets. Is this the best form of treatment to reduce the high blood pressure and pressure on the heart? Will the hydrochlorothiazide adversely affect the gout attacks once again and, what would there be any adverse affects and pressure on my kidneys if this form of treatment were to continue in the future. THANK-YOU.