Increased Risk of Stroke in Constipation Patients: Systematic Review and Meta-analysis

Constipation is commonly seen among patients with cardiovascular diseases and is linked to adverse outcomes. However, the association between constipation and the risk of stroke remains conflicting. Therefore, we aim to conduct a systematic review and meta-analysis to summarize the available data on this topic.

We identified potentially eligible studies from the MEDLINE and EMBASE databases, searching from inception to May 2024, to investigate the association between constipation and stroke. To be included, studies needed to compare the incidence of stroke between groups with and without constipation. Effect size and 95% CIs were combined using the generic inverse variance method.

Our meta-analysis included 8 studies that met the eligibility criteria. There were 5,360,573 participants, with a mean age of 53.9 years and 69% are males. We found that patients with constipation have a 41% increased risk of stroke with a pooled risk ratio of 1.41 (95% CI: 1.13-1.75; P < 0.01, I2 = 99%) compared with those without constipation. Subgroup analysis revealed that patients with constipation have a 50% increased risk of ischemic stroke with a pooled risk ratio of 1.50 (95% CI: 1.15-1.96; P < 0.01, I2 = 99%), but no statistical significance was found for mixed-type stroke outcome.

Our study revealed that constipation is associated with a higher risk of stroke. These findings could influence future strategies for cardiovascular disease prevention and management in patients with chronic constipation.