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Hyperuricemia and risk of stroke: A systematic review and meta‐analysis
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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. Conclusion: 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.
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“[Statement]Hyperuricemia can be regarded as a risk factor for ASCVD. (Evidence level: E2)”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [206]
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Metadata
- Authors
- Kim, S. Y., Guevara, J. P., Kim, K. M., Choi, H. K., Heitjan, D. F., & Albert, D. A.
- Affiliations
- Children's Hospital of Philadelphia (US)
- Pusan National University (KR)
- University of British Columbia (CA)
- University of Pennsylvania (US)
- Dartmouth–Hitchcock Medical Center (US)
- Venue
- Arthritis Care & Research
- Publisher
- Wiley
- Published
- 2009-06-29
- Volume
- 61
- Issue
- 7
- Pages
- 885-892
- ISSN
- 0893-7524 (ISSN-L)
- 1529-0123
- PMC
- PMC2714267
- OpenAlex
- W2002849282
- Cited by
- 484
- References
- 62
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 21 · 2023: 21 · 2022: 25 · 2021: 36 · 2020: 32 · 2019: 28 · 2018: 23 · 2017: 29 · 2016: 42 · 2015: 55 · 2014: 29 · 2013: 40 · 2012: 30
- FWCI
- 3.66
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Arthritis Care & Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (T32AR007442)
- Topics
- Health Sciences › Medicine › Nephrology › Gout, Hyperuricemia, Uric Acid
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- hyperuricemia, serum uric acid, stroke incidence, stroke mortality, cardiovascular risk factors, hypertension, diabetes mellitus, cholesterol, sex differences
- MeSH terms
- Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Risk Factors, Uric Acid, Incidence, Stroke, Hyperuricemia, Young Adult
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