Hyperuricemia and the risk of stroke incidence and mortality: a systematic review and meta-analysis

Abstract

Background. The relationship between hyperuricemia (HUA) and stroke remains controversial. The aim of this systematic re-view was to assess the association between hyperuricemia and stroke. Methods. PubMed, Embase, Web of Science and Cochrane Library were searched from their earliest records to June 5th, 2023, additional papers were identified through a manual search. Prospective studies that provided a multivariate-adjusted estimate of the association between hyperuricemia and risk of stroke incidence and mortality, represented as relative risks (RRs) with 95% confidence intervals (CIs), were eligible. Results. A total of 22 studies including 770532 adults were eligible and included. Hyperuricemia was associated with a significantly increasing risk of both stroke incidence (combined RR, 1.42; 95%CI, 1.31–1.53) and stroke mortality (combined RR, 1.53; 95%CI, 1.18–1.99) in our meta-analyses. Relative risk of stroke incidence: females (combined RR, 1.67 ; 95%CI, 1.44–1.92) and males (combined RR, 1.13; 95%CI, 1.02–1.25). Relative risk of mortality: female (combined RR, 1.41 ; 95%CI, 1.31–1.52) and males (combined RR, 1.27; 95%CI, 1.20–1.34). The association between hyperuricemia and ischemic stroke (IS) (combined RR, 1.39; 95%CI, 1.31–1.47) was more significant than that of hemorrhagic stroke (HS) (combined RR, 1.13; 95%CI, 1.02–1.26). Conclusion. Our study verified an association between hyperuricemia and risk of stroke, which was more pronounced in females.