Osteoarthritis and incidence of stroke and transient ischemic attack in 320,136 adults followed in general practices in the United Kingdom

Objective: The goal of this study was to investigate the relationship of osteoarthritis with stroke and transient ischemic attack in the United Kingdom.

Methods: This study included patients who received a first diagnosis of osteoarthritis in one of 256 general practices in the United Kingdom between 1997 and 2016 (index date). Patients without osteoarthritis were matched (1:1) to those with osteoarthritis using propensity scores based on sex, age, index year, general practice, and vascular risk factors documented in the 12 months prior to the index date (hypertension, obesity, diabetes mellitus, dyslipidemia, and atrial fibrillation). For individuals without osteoarthritis, the index date corresponded to a randomly selected visit date between 1997 and 2016. The relationship between osteoarthritis and the incidence of both stroke and transient ischemic attack was studied using Kaplan-Meier curves and Cox regression analyses.

Results: This study included 160,068 patients with osteoarthritis and 160,068 patients without osteoarthritis (61.6% women; mean age [standard deviation] 64.2 [14.2] years). The 10-year incidence of stroke (4.5% versus 3.0%) and transient ischemic attack (3.3% versus 2.0%) was significantly higher in individuals with than in those without osteoarthritis. The Cox regression analyses also showed that osteoarthritis was positively associated with both stroke (hazard ratio [HR]=1.45, 95% confidence interval [CI]=1.39-1.51) and transient ischemic attack (HR=1.55, 95% CI=1.47-1.63).

Conclusions: These findings suggest that osteoarthritis may be associated with an increase in the incidence of stroke and transient ischemic attack. Further research of longitudinal design is warranted to confirm or reject these results.