title: Increased risk of stroke in patients with osteoarthritis: a population-based cohort study.
abstract: Osteoarthritis (OA) is related to carotid atherosclerosis. Few studies have investigated the incidence of cerebrovascular diseases in patients with OA. Therefore, we conducted a population-based cohort study to determine the incidence and risk of stroke in patients with OA.
  
  
  
  We used data from Taiwan's Longitudinal Health Insurance Database 2000 (LHID2000) to investigate the incidence of stroke in 43,635 patients with OA newly diagnosed between 2002 and 2003. The non-osteoarthritis (non-OA) cohort comprised 43,635 people from the general population. The follow-up period was from the index date of OA to the date of censoring date or stroke diagnosis, or to the end of 2010.
  
  
  
  The overall incidence of stroke was 36% higher in the OA cohort than in the non-OA cohort, with an adjusted hazard ratio (aHR) of 1.10 (95% confidence interval [CI] = 1.06-1.14) after adjustment for covariates. Men, age, comorbidity, non-selective nonsteroidal anti-inflammatory drugs (NSAIDs), and Cox-2 selective NSAIDs are independent risk factors of stroke. The OA adults with mild to moderate OA (aHR = 1.97, 95% CI = 1.70-2.28 for young adults; aHR = 1.33, 95% CI = 1.25-1.42 for middle-aged adults; aHR = 1.16, 95% CI = 1.12-1.21 for older adults) and severe OA (aHR = 3.78, 95% CI = 2.50-5.70 for young adults; aHR = 1.34, 95% CI = 1.16-1.56 for middle-aged adults; and aHR = 1.01, 95% CI = 0.92-1.10 for older adults) exhibited increased risks of stroke compared with their counterparts without OA.
  
  
  
  OA may be associated with a slightly increased risk of stroke.
authors.affiliation: Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan.
authors.forename: P-S
authors.initials: PS
authors.lastname: Hsu
authors.affiliation: Department of Management Information Systems, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: H-H
authors.initials: HH
authors.lastname: Lin
authors.affiliation: School of Nursing, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: C-R
authors.initials: CR
authors.lastname: Li
authors.affiliation: Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Department of Health Services Administration, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan. Electronic address: chung.w53@msa.hinet.net.
authors.forename: W-S
authors.initials: WS
authors.lastname: Chung
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Cohort study; Osteoarthritis; Stroke