Abstract
BackgroundOsteoarthritis (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.MethodsWe 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 case-control analysis was used to identify factors associated with the stroke in the OA cohort.ResultsThe 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 case-control 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.ConclusionWomen 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.
Highlights
Osteoarthritis (OA) is a progressing inflammatory disorder of joint cartilage and underlying bone primarily due to injury
The present study aims to investigate whether women with OA are at an increased risk of subsequent occurrence of ischemic stroke using the National Health Insurance Research Database (NHIRD) of Taiwan
The study population consisted of 13,520 women in the osteoarthritis cohort and 27,033 women in the comparison cohort, with the same mean age of 50.1 years (Table 1)
Summary
Osteoarthritis (OA) is a progressing inflammatory disorder of joint cartilage and underlying bone primarily due to injury. The elderly with this disorder are at an increased risk of disability of multiple joints and impaired quality of life.[1] There are multiple factors leading to OA, including traumatic injury, aging, obesity, and other biomechanical disorders.[2,3] The disease is more prevalent in women than in men, and prevalence increases with age, especially after 50 years of age, maybe due to hormonal change.[4,5,6,7] OA of the knee and hand are more prevalent than the OA of hip.[6,8].
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