Women With Osteoarthritis Are at Increased Risk of Ischemic Stroke: A Population-Based Cohort Study

Abstract

Background: Osteoarthritis (OA) is more prevalent in women with age. Comorbidities are prevalent in OA patients. In this study, we conducted a follow-up study to evaluate whether women with OA are at an increased risk of ischemic stroke using insurance claims data of Taiwan. Methods: We identified 13,520 women with OA aged 20-99 newly diagnosed in 2000-2006 and 27,033 women without OA for comparison, frequency matched by age and diagnosis date. Women with baseline history of hypertension and other disorders associated with stroke were excluded for this study. Incident ischemic stroke was assessed by the end of 2013. A nested casecontrol analysis was used to identify factors associated with the stroke in the OA cohort. Results: The incidence rate of ischemic stroke in the OA cohort was 1.5-fold greater than that in comparisons (1.93 versus 1.26 per 1,000 person-years), with an adjusted hazard ratio of 1.34 (95% confidence interval [CI], 1.09-1.66). The nested casecontrol analysis showed that stroke cases were twice as likely to develop hypertension during the follow-up period than controls without stroke. The ischemic stroke risk was significantly associated with hypertension (odds ratio [OR] 1.84; 95% CI, 1.37-2.46) and atrial fibrillation (OR 2.25; 95% CI, 1.24-4.09). Ischemic stroke was not associated with the use of non-steroidal anti-inflammatory drugs or aspirin. Conclusion: Women with OA are at an elevated risk of ischemic stroke. A close monitoring of hypertension, atrial fibrillation, and other stroke related comorbidities is required for stroke prevention for OA patients.

Causal Relationships Between Osteoarthritis and Senile Central Nerve System Dysfunction: A Bidirectional Two-Sample Mendelian Randomization Study

“…In this study, our MR analysis showed that there was no evidence of a causal effect of OA on IS (OR = 0.983, 95%CI = 0.872, 1.087; P = 0.780). This is different from some previous studies ( Jacob et al, 2021 ; Yeh et al, 2021 ), suggesting that OA might not increase the risk of IS, but the treatment of OA might. Conversely, our results supported the positive causal effect of IS on OA (OR = 1.033, 95%CI = 1.002, 1.066; P = 0.0355).…”

“…Ischemic stroke is a cerebrovascular disease with an increasing incidence, has a high disability and mortality rate, and leads to sequelae or serious complications, significantly affecting the quality of life. The relationship between stroke and OA has been repeatedly reported (Hsu et al, 2017;Yeh et al, 2021). For example, Hsu et al (2017) performed a population-based cohort study and concluded that OA might contribute to the increased risk of stroke.…”

“…In recent years, there has been a growing attention to the relationship between OA and senile CNSD. For example, studies have suggested that OA-related inflammation and pain might increase the risk of PD and ADL ( Ikram et al, 2019 ; Roper et al, 2020 ; Feng et al, 2021 ), and an increasing number of studies have demonstrated the causal effects of OA on stroke ( Hsu et al, 2017 ; Yeh et al, 2021 ). However, most of these studies were retrospective, in which the confounders and biases, such as selection bias and memory bias, could not be eliminated, and reverse causality might also have occurred.…”

The impact of ankle-foot orthosis's plantarflexion resistance on knee adduction moment in people with chronic stroke

“…Ten people in the chronic stage of poststroke recovery (eight men/ two women, four left side involvement/six right side involvement, and at least 6-month poststroke) participated in this study. Their basic demographic information is as follows: age (mean [SD]): 56 (11) years; body height (mean [SD]): 1.76 (0.11) m; and body mass (mean [SD]): 99 (17) kg. The inclusion criteria were as follows: 1) hemiplegia because of stroke, 2) at least 6-month poststroke, 3) foot drop while walking, 4) ability to walk on the instrumented treadmill, and 5) ability to use an articulated AFO.…”

“…Knee osteoarthritis is reported to negatively affect ambulation capability of people with stroke. 10 It is also reported that people with osteoarthritis tend to have a higher risk of stroke, 11,12 and stroke is one of the most common risk factors for them. 13 In addition, sonographic arthritic changes are reported in the knees of people with stroke.…”