期刊
STROKE
卷 52, 期 8, 页码 2601-2608出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/STROKEAHA.120.032995
关键词
comorbidity; hypertension; obesity; obsessive-compulsive disorder; risk factors
资金
- Taipei Veterans General Hospital [V106B-020, V107B-010, V107C-181, V108B-012]
- Yen Tjing Ling Medical Foundation [CI-110-30]
- Ministry of Science and Technology, Taiwan [107-2314-B-075-063-MY3, 108-2314-B-075-037]
Patients with obsessive-compulsive disorder (OCD) have a higher risk of ischemic stroke, especially middle-aged and elderly adults, but no significant difference in hemorrhagic stroke risk. The use of OCD medications does not appear to affect the occurrence of stroke.
Background and Purpose: Patients with obsessive-compulsive disorder (OCD) tend to be comorbid with stroke-related risk factors, including obesity, hypertension, and diabetes. However, the temporal association between OCD and subsequent stroke risk is unclear. Methods: Using data collected between 2001 and 2010 by Taiwan's National Health Insurance Research Database, 28 064 adult patients with OCD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code: 300.3) and 28 064 age-, sex-, and comorbidity-matched controls were included in this study. Patients who developed ischemic (ICD-9-CM codes: 433, 434, and 435) and hemorrhagic (ICD-9-CM codes: 430, 431, and 432) stroke during follow-up (from enrollment to end of 2011) were identified. Moreover, medications used for treating OCD were assessed. Results: Patients with OCD (hazard ratio [HR], 3.02 [95% CI, 1.91-4.77]), especially middle-aged (HR, 2.66 [95% CI, 1.34-5.29]) and elderly adults (HR, 3.46 [95% CI, 1.70-7.05]), had an elevated risk of developing ischemic stroke during the follow-up period compared with non-OCD controls. The cumulative HR of hemorrhagic stroke did not differ (HR, 0.87 [95% CI, 0.42-1.80]) between the OCD and non-OCD groups. In patients with OCD, both short- (HR, 1.69 [95% CI, 0.74-3.88]; HR, 0.31 [95% CI, 0.05-1.95]) and long-term use (HR, 1.37 [95% CI, 0.60-3.16]; HR, 0.90 [95% CI, 0.22-3.76]) of OCD medications were not correlated with ischemic and hemorrhagic stroke compared with nonuse. Conclusions: Clinicians should closely monitor cerebrovascular disease and related risks in patients with OCD. The pathomechanism of OCD with an increased risk of ischemic stroke warrants further investigation.
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