Serum uric acid and risk of ischemic stroke: The ARIC Study

Atsushi Hozawa; Aaron R. Folsom; Hassan Ibrahim; F. Javier Nieto; Wayne D. Rosamond; Eyal Shahar

doi:10.1016/j.atherosclerosis.2005.09.020

Serum uric acid and risk of ischemic stroke: The ARIC Study

Atsushi Hozawa, Aaron R. Folsom, Hassan Ibrahim, F. Javier Nieto, Wayne D. Rosamond, Eyal Shahar

Department of Medicine

Research output: Contribution to journal › Article › peer-review

130 Scopus citations

Abstract

Aims: Since serum uric acid (UA) is strongly associated with cardiovascular risk factors, it has been debated whether serum UA is a stroke risk factor or whether UA may be simply "marking" subjects with other, causal risk factors. We therefore investigated the relation between UA and ischemic stroke in the Atherosclerosis Risk in Communities (ARIC) Study. Methods and results: Of 15,792 ARIC participants, 13,413 who were free of recognized stroke or coronary heart disease (CHD) at baseline and had a baseline UA measurement were included in the analysis. We followed the participants for ischemic stroke incidence (N = 381) over 12.6 years. Although serum UA was independently and positively related to ischemic stroke incidence when we adjusted for age, sex, race, and education, the positive relation was weakened when additionally adjusted for possible confounding variables. The positive multivariate-adjusted association between serum UA and ischemic stroke was observed among subjects not using diuretics (adjusted relative hazard in the highest quartile versus the lowest: relative hazard (RH) = 1.49; 95% confidence interval (CI): 1.00-2.23) (P for trend: 0.02), but not among diuretic users (P for interaction: 0.08). Conclusion: Our findings suggest that UA is an independent predictor of ischemic stroke among subjects not using diuretics, but that elevated UA itself may not cause ischemic stroke.

Original language	English (US)
Pages (from-to)	401-407
Number of pages	7
Journal	Atherosclerosis
Volume	187
Issue number	2
DOIs	https://doi.org/10.1016/j.atherosclerosis.2005.09.020
State	Published - Aug 2006

Keywords

Diuretics
Prospective studies
Stroke
Uric acid

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.atherosclerosis.2005.09.020

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title = "Serum uric acid and risk of ischemic stroke: The ARIC Study",

abstract = "Aims: Since serum uric acid (UA) is strongly associated with cardiovascular risk factors, it has been debated whether serum UA is a stroke risk factor or whether UA may be simply {"}marking{"} subjects with other, causal risk factors. We therefore investigated the relation between UA and ischemic stroke in the Atherosclerosis Risk in Communities (ARIC) Study. Methods and results: Of 15,792 ARIC participants, 13,413 who were free of recognized stroke or coronary heart disease (CHD) at baseline and had a baseline UA measurement were included in the analysis. We followed the participants for ischemic stroke incidence (N = 381) over 12.6 years. Although serum UA was independently and positively related to ischemic stroke incidence when we adjusted for age, sex, race, and education, the positive relation was weakened when additionally adjusted for possible confounding variables. The positive multivariate-adjusted association between serum UA and ischemic stroke was observed among subjects not using diuretics (adjusted relative hazard in the highest quartile versus the lowest: relative hazard (RH) = 1.49; 95% confidence interval (CI): 1.00-2.23) (P for trend: 0.02), but not among diuretic users (P for interaction: 0.08). Conclusion: Our findings suggest that UA is an independent predictor of ischemic stroke among subjects not using diuretics, but that elevated UA itself may not cause ischemic stroke.",

keywords = "Diuretics, Prospective studies, Stroke, Uric acid",

author = "Atsushi Hozawa and Folsom, {Aaron R.} and Hassan Ibrahim and {Javier Nieto}, F. and Rosamond, {Wayne D.} and Eyal Shahar",

note = "Funding Information: The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. The authors thank the staff and participants of the ARIC study for their important contributions. Funding Information: Dr. Hozawa was supported by a grant (14010301) from the Japan Society for the Promotion of Science Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan and the Banyu Fellowship Program sponsored by Banyu Life Science Foundation International. ",

year = "2006",

month = aug,

doi = "10.1016/j.atherosclerosis.2005.09.020",

language = "English (US)",

volume = "187",

pages = "401--407",

journal = "Atherosclerosis",

issn = "0021-9150",

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number = "2",

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TY - JOUR

T1 - Serum uric acid and risk of ischemic stroke

T2 - The ARIC Study

AU - Hozawa, Atsushi

AU - Folsom, Aaron R.

AU - Ibrahim, Hassan

AU - Javier Nieto, F.

AU - Rosamond, Wayne D.

AU - Shahar, Eyal

N1 - Funding Information: The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. The authors thank the staff and participants of the ARIC study for their important contributions. Funding Information: Dr. Hozawa was supported by a grant (14010301) from the Japan Society for the Promotion of Science Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan and the Banyu Fellowship Program sponsored by Banyu Life Science Foundation International.

PY - 2006/8

Y1 - 2006/8

N2 - Aims: Since serum uric acid (UA) is strongly associated with cardiovascular risk factors, it has been debated whether serum UA is a stroke risk factor or whether UA may be simply "marking" subjects with other, causal risk factors. We therefore investigated the relation between UA and ischemic stroke in the Atherosclerosis Risk in Communities (ARIC) Study. Methods and results: Of 15,792 ARIC participants, 13,413 who were free of recognized stroke or coronary heart disease (CHD) at baseline and had a baseline UA measurement were included in the analysis. We followed the participants for ischemic stroke incidence (N = 381) over 12.6 years. Although serum UA was independently and positively related to ischemic stroke incidence when we adjusted for age, sex, race, and education, the positive relation was weakened when additionally adjusted for possible confounding variables. The positive multivariate-adjusted association between serum UA and ischemic stroke was observed among subjects not using diuretics (adjusted relative hazard in the highest quartile versus the lowest: relative hazard (RH) = 1.49; 95% confidence interval (CI): 1.00-2.23) (P for trend: 0.02), but not among diuretic users (P for interaction: 0.08). Conclusion: Our findings suggest that UA is an independent predictor of ischemic stroke among subjects not using diuretics, but that elevated UA itself may not cause ischemic stroke.

AB - Aims: Since serum uric acid (UA) is strongly associated with cardiovascular risk factors, it has been debated whether serum UA is a stroke risk factor or whether UA may be simply "marking" subjects with other, causal risk factors. We therefore investigated the relation between UA and ischemic stroke in the Atherosclerosis Risk in Communities (ARIC) Study. Methods and results: Of 15,792 ARIC participants, 13,413 who were free of recognized stroke or coronary heart disease (CHD) at baseline and had a baseline UA measurement were included in the analysis. We followed the participants for ischemic stroke incidence (N = 381) over 12.6 years. Although serum UA was independently and positively related to ischemic stroke incidence when we adjusted for age, sex, race, and education, the positive relation was weakened when additionally adjusted for possible confounding variables. The positive multivariate-adjusted association between serum UA and ischemic stroke was observed among subjects not using diuretics (adjusted relative hazard in the highest quartile versus the lowest: relative hazard (RH) = 1.49; 95% confidence interval (CI): 1.00-2.23) (P for trend: 0.02), but not among diuretic users (P for interaction: 0.08). Conclusion: Our findings suggest that UA is an independent predictor of ischemic stroke among subjects not using diuretics, but that elevated UA itself may not cause ischemic stroke.

KW - Diuretics

KW - Prospective studies

KW - Stroke

KW - Uric acid

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Serum uric acid and risk of ischemic stroke: The ARIC Study

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