Peptic Ulcer Does Not Increase the Risk of Stroke: a Longitudinal Follow-up Study Using a National Sample Cohort

Abstract Background: Studies have reported that several gastrointestinal diseases increase the risk of stroke. We aimed to evaluate the risk of stroke in patients with peptic ulcer disease (PUD) using a national sample cohort from South Korea. Methods: We extracted data entered into the Korean National Health Insurance Service for patients with PUD (n = 129,531) and for 1:1 matched control participants (n = 129,531) and analyzed the risk of stroke using Cox proportional hazard model. Subgroup analyses were performed based on age and sex.Results: The rates of hemorrhagic and ischemic stroke were lower in the PUD group than in the control group. In a subgroup analysis according to age, the adjusted hazard ratios (HRs) of PUD for hemorrhagic and ischemic stroke were 0.76 (95% CI = 0.63-0.90) and 0.85 (95% CI = 0.73-0.98) in the < 50-year-old group and 0.72 (95% CI = 0.65-0.80) and 0.84 (95% CI = 0.80-0.89) in the ≥ 50-year-old group, respectively (each p < 0.05). In a subgroup analysis according to sex, the adjusted HRs of PUD were 0.71 (95% CI = 0.63-0.81) and 0.81 (95% CI = 0.5-0.87) in men and 0.75 (95% CI = 0.66-0.86) and 0.88 (95% CI = 0.82-0.95) in women, respectively (each p < 0.05).Conclusions: Our study concluded that PUD does not increase the risk of ischemic or hemorrhagic stroke regardless of age and sex.