Increased risk of stroke in patients with osteoarthritis: a population-based cohort study

Hsu, Pi-Shan; Lin, Hung Hsin; Li, C.-R.; Chung, Wei‐Sheng

doi:10.1016/j.joca.2016.10.027

Cited by 47 publications

(43 citation statements)

References 34 publications

(27 reference statements)

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“…Cardiovascular and cerebrovascular outcomes in osteoarthritis are documented, where individuals with osteoarthritis have a higher risk of experiencing a vascular‐related incident than those without osteoarthritis (Calvet et al ; Hall et al ; Hsu et al ). In a population‐based cohort study examining all‐cause and disease specific mortality of adults with either knee or hip OA (>1000 individuals and >35 years of age), age‐ and sex‐standardized mortality and hazard ratios were higher in OA than those without OA, and of particular interest, excess mortality was pronounced for cardiovascular disease and dementia associated mortality (Nuesch et al ).…”

Section: Discussionmentioning

confidence: 99%

“…All‐cause mortality in people with osteoarthritis (OA) is related to cardiovascular disease (CVD) (Calvet et al ; Hall et al ; Veronese et al ), and a greater risk of cerebrovascular disease such as stroke (Hsu et al ). Osteoarthritis shares several disease characteristics with CVD and cerebrovascular disease: hypertension (Veronese et al ), arterial intima media thickening (IMT) (Hoeven et al ), and endothelial dysfunction (via flow‐mediated dilation; FMD) (Alkatan et al ).…”

Section: Introductionmentioning

confidence: 99%

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Exploring Cerebrovascular Function in Osteoarthritis: “Heads‐up”

et al. 2019

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Individuals with osteoarthritis (OA) are at greater risk of cardiovascular and cerebrovascular incidents; yet, cerebrovascular control remains uncharacterized. Our primary outcome was to acquire cerebrovascular control metrics in patients with OA and compare measures to healthy control adults (CTL) without OA or cardiovascular complications. Our primary covariate was a 10‐year risk factor for cardiovascular and stroke incidents, and secondary covariates were other cardiovascular disease risk factors (i.e., body mass index, carotid intima media thickness, and brachial flow‐mediated dilation). Our secondary outcomes were to assess anatomical and functional changes that may be related to cerebrovascular reactivity were also acquired such as white matter lesion volume and brief cognitive assessments. In 25 adults (n = 13 CTL, n = 12 OA), under hypercapnia, magnetic resonance imaging (3T) was used to acquire a “Global Cerebrovascular Reactivity” index across the larger intracranial cerebral arteries and white matter lesions, and transcranial Doppler was used for both middle cerebral artery hemodynamic responses to hypercapnia and to assess autoregulation via a sit‐to‐stand task. Compared to CTL, OA had lower “Global Cerebrovascular Reactivity” index responses to hypercapnia, autoregulatory responses, and greater white matter lesions (P < 0.05). These differences persisted after covarying for the outlined primary and secondary covariates. Patients with OA, in the absence of known cardiovascular disease, can exhibit pre‐clinical and impaired (compared to CTL) peripheral and cerebrovascular control metrics.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring Cerebrovascular Function in Osteoarthritis: “Heads‐up”

et al. 2019

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“…We reviewed the full text of the selected 15 articles, and also assessed their reference lists for relevant articles. Based on the review, 13 studies [17][18][19][20][21][22][23][24][25][26][27][28][29] met all of our study inclusion criteria. Figure 1 summarized our selection process.…”

Section: Study Screeningmentioning

confidence: 99%

“…Eight of these studies were case-control design studies [18][19][20][21][22][23][24]28], and 5 were cohort studies [18,19,24,26,27]. The date of the publication of the 13 studies was 1999 [20] to 2017 [17]. Five studies were conducted in Europe [20,24,26,27], 4 in Asia [17,[21][22][23], 3 in Australia [20,25,28], and 1 in North America [29].…”

Section: Study Characteristicsmentioning

confidence: 99%

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Risk of Hemorrhagic Stroke in Patients Exposed to Nonsteroidal Anti-Inflammatory Drugs: A Meta-Analysis of Observational Studies

et al. 2018

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Background and Aim: Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most common pain relief medications, but the risk of hemorrhagic stroke in patients taking these medications is unclear. In this study, our aim was to systematically review, synthesize, and critique the epidemiological studies that evaluate the association between NSAIDs and hemorrhagic stroke risk. We therefore assessed the current state of knowledge, filling the gaps in our existing concern, and make a recommendation for future research. Methods: We searched for articles in PubMed, EMBASE, Scopus, and Web of Science between January 1, 1990, and July 30, 2017, which reported on the association between the use of NSAIDs and hemorrhagic stroke. The search was limited to studies published in English. The quality of the included studies was assessed in accordance with the Cochrane guidelines and the Newcastle-Ottawa criteria. Summary risk ratios (RRs) with 95% CI were pooled using a random-effects model. Subgroup and sensitivity analyses were also conducted. Results: We selected 15 out of the 785 unique abstracts for full-text review using our selection criteria, and 13 out of these 15 studies met all of our inclusion criteria. The overall pooled RR of hemorrhagic stroke was 1.332 (95% CI 1.105–1.605, p = 0.003) for the random effect model. In the subgroup analysis, a significant risk was observed among meloxicam, diclofenac, and indomethacin users (RR 1.48; 95% CI 1.149–1.912, RR 1.392; 95% CI 1.107–1.751, and RR 1.363; 95% CI 1.088–1.706). In addition, a greater risk was found in studies from Asia (RR 1.490, 95% CI 1.226–1.811) followed by Europe (RR 1.393, 95% CI 1.104–1.757) and Australia (RR 1.361, 95% CI 0.755–2.452). Conclusion: Our results indicated that the use of NSAIDs is significantly associated with a higher risk of developing hemorrhagic stroke. These results should be interpreted with caution because they may be confounded owing to the observational design of the individual studies. Nevertheless, we recommend that NSAIDs should be used judiciously, and their efficacy and safety should be monitored proactively.

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Association of Osteoarthritis With Increased Risk of Parkinson's Disease: A Population‐Based, Longitudinal Follow‐Up Study

Feng

Chuang

Yeh

et al. 2022

Arthritis Care & Research

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Objective. To investigate whether patients with osteoarthritis (OA) are at a higher risk of developing Parkinson's disease (PD).Methods. This retrospective cohort study was conducted using Taiwan's Longitudinal Health Insurance Database 2005. We enrolled 33,360 patients who were 50-64 years old and had OA in 2002-2005 to form the OA group. The comparison group consisted of 33,360 age-and sex-matched, randomly sampled subjects without OA. Then, their PD-free survival curves were generated using the Kaplan-Meier method. Multivariable Cox proportional hazards regression analysis was employed to estimate the effect of having OA on patients' subsequent risk of PD.Results. Of the 2 groups, the OA group had a significantly higher risk of developing PD (adjusted hazard ratio [HR adj ] 1.41 [95% confidence interval (95% CI) 1.16-1.70], P = 0.0003). The PD-free survival rate of the OA group was also significantly lower than that of the comparison group (P = 0.0004). The subgroup analysis showed that patients with knee or hip OA appeared to have a higher magnitude of PD risk (HR adj 1.55 [95% CI 1.14-2.11]) than patients with non-knee and non-hip OA (HR adj 1.42 [95% CI 1.06-1.89]) or with uncategorized OA (HR adj 1.32 [95% CI 1.05-1.64]).Conclusion. Our findings suggest that OA is linked to an increased risk of developing PD.

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Increased risk of stroke in patients with osteoarthritis: a population-based cohort study

Abstract: OA may be associated with a slightly increased risk of stroke.

Cited by 47 publications

References 34 publications

Exploring Cerebrovascular Function in Osteoarthritis: “Heads‐up”

Exploring Cerebrovascular Function in Osteoarthritis: “Heads‐up”

Risk of Hemorrhagic Stroke in Patients Exposed to Nonsteroidal Anti-Inflammatory Drugs: A Meta-Analysis of Observational Studies

Association of Osteoarthritis With Increased Risk of Parkinson's Disease: A Population‐Based, Longitudinal Follow‐Up Study

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