title: Hyperuricemia and risk of stroke: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To assess the association between hyperuricemia and risk of stroke incidence and mortality because hyperuricemia is hypothesized to be a risk factor for stroke and other cardiovascular disease, but, to date, results from observational studies are conflicting.
  
  
  METHODS
  A systematic review and meta-analysis were conducted. Studies were identified by searching major electronic databases using the Medical Subject Headings and keywords without restriction in languages. Prospective cohort studies were included only if they contained data on stroke incidences or mortalities related to serum uric acid levels in adults. Pooled risk ratios (RRs) for the association of stroke incidence and mortality with serum uric acid levels were calculated.
  
  
  RESULTS
  A total of 16 studies including 238,449 adults were eligible and abstracted. Hyperuricemia was associated with a significantly higher risk of both stroke incidence (6 studies; RR 1.41, 95% confidence interval [95% CI] 1.05, 1.76) and mortality (6 studies; RR 1.36, 95% CI 1.03, 1.69) in our meta-analyses of unadjusted study estimates. Subgroup analyses of studies adjusting for known risk factors such as age, hypertension, diabetes mellitus, and cholesterol still showed that hyperuricemia was significantly associated with both stroke incidence (4 studies; RR 1.47, 95% CI 1.19, 1.76) and mortality (6 studies; RR 1.26, 95% CI 1.12, 1.39). The pooled estimate of multivariate RRs did not differ significantly by sex.
  
  
  CONCLUSIONS
  Hyperuricemia may modestly increase the risks of both stroke incidence and mortality. Future research is needed to determine whether lowering uric acid level has any beneficial effects on stroke.
authors: University of Pennsylvania, Philadelphia, PA 19104, USA. seo.kim@uphs.upenn.edu
authors: Seo Young
authors: SY
authors: Kim
authors: James P
authors: JP
authors: Guevara
authors: Kyoung Mi
authors: KM
authors: Kim
authors: Hyon K
authors: HK
authors: Choi
authors: Daniel F
authors: DF
authors: Heitjan
authors: Daniel A
authors: DA
authors: Albert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D033461:Hyperuricemia / Q000097:blood / Q000150:complications* / Q000401:mortality; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D014527:Uric Acid / Q000097:blood; D055815:Young Adult
chemical_list: D014527:Uric Acid