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Rheumatoid arthritis and stroke risk: a systematic review and meta-analysis.

Lulu Yang1,2,3,4, Xinyu Liu1,2, Guangyuan Yang5

  • 1Rehabilitation Medical College, Jiamusi University, Jiamusi, Heilongjiang, China.

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Rheumatoid arthritis (RA) significantly increases stroke risk. This meta-analysis confirms RA as an independent risk factor, particularly in women and individuals over 65.

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Area of Science:

  • Rheumatology
  • Neurology
  • Epidemiology

Background:

  • Rheumatoid arthritis (RA) is a chronic inflammatory disease.
  • The association between RA and cardiovascular events, including stroke, requires further elucidation.

Purpose of the Study:

  • To conduct a meta-analysis evaluating the association between rheumatoid arthritis (RA) and stroke risk.
  • To identify RA as an independent risk factor for stroke.

Main Methods:

  • A systematic literature search was performed across PubMed, Cochrane Library, and Embase up to October 7, 2025.
  • Random effect models were employed to calculate odds ratios (OR) and 95% confidence intervals (CI) for the RA-stroke association.
  • Publication bias was assessed using funnel plots and Egger's/Begg's tests.

Main Results:

  • The meta-analysis included 12 observational studies with 1,715,001 participants.
  • A significant association was found between RA and increased stroke risk (OR = 1.35; 95% CI [1.26-1.45]).
  • Subgroup analyses indicated higher stroke risk in women with RA (OR = 1.60) and those over 65 (OR = 1.24).

Conclusions:

  • Rheumatoid arthritis is associated with a significantly increased risk of stroke.
  • RA should be recognized as an independent risk factor for stroke.
  • Further research may focus on targeted stroke prevention strategies for RA patients.