The Association Between Peptic Ulcer Disease and Ischemic Stroke: A Population-Based Longitudinal Study
Tain-Junn Cheng1, How-Ran Guo, Chia-Yu Chang
1From the Department of Neurology (T-JC, C-YC); Department of Occupational Medicine (T-JC), Chi Mei Medical Center, Yongkang; Department of Occupational Safety and Disaster Prevention (T-JC), College of Sustainable Environment, Chia Nan University of Pharmacy and Science, Jen-Te; Department of Environmental and Occupational Health (H-RG, P-IL), College of Medicine; Department of Occupational and Environmental Medicine (H-RG), National Cheng Kung University Hospital; Center for General Education (C-YC), Southern Taiwan University, Yongkang, Tainan; Department of Healthcare Administration and Medical Informatics (S-FW), Kaohsiung Medical University, Kaohsiung; Department of Family Medicine (P-IL); Department of Medical Research (J-JW); Department of Internal Medicine (W-SW), Chi Mei Medical Center; and Department of Pharmacy (W-SW), Chia Nan University of Pharmacy and Science, Jen-Te, Tainan, Taiwan.
Peptic ulcer disease (PUD) is linked to a higher risk of ischemic stroke (IS), even when considering other common risk factors. This finding suggests PUD may be an independent risk factor for stroke.
Area of Science:
- Cardiovascular epidemiology
- Gastroenterology
- Public health
Background:
- Stroke is a leading global cause of mortality.
- A significant portion of ischemic stroke (IS) cases lack identifiable risk factors.
- Peptic ulcer disease (PUD) and vascular events share common risk factors, prompting investigation into their association.
Purpose of the Study:
- To investigate the association between peptic ulcer disease (PUD) and the risk of ischemic stroke (IS).
- To determine if PUD is an independent risk factor for IS, beyond conventional risk factors.
Main Methods:
- A population-based cohort study utilizing Taiwan's National Health Insurance Research Database (1997-2011).
- Inclusion of 1 million residents, with a defined PUD group and an age/sex-matched control group without PUD.
- Analysis using Cox proportional hazard models to compare IS incidence between groups, adjusting for medical history and income.
Main Results:
- The PUD group exhibited a higher incidence of IS, with an adjusted hazard ratio of 1.31 (95% CI: 1.20-1.41).
- PUD patients had higher prevalence of hypertension, diabetes mellitus (DM), heart disease, and hyperlipidemia.
- Independent risk factors for IS included male sex, older age, lower income, and comorbidities like hypertension, DM, and heart disease.
Conclusions:
- Peptic ulcer disease (PUD) is identified as an independent risk factor for ischemic stroke (IS).
- This association persists even after accounting for conventional risk factors.
- Development of targeted prevention strategies for IS in PUD patients is recommended.
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