Hyperuricemia and the risk of stroke incidence and mortality: A systematic review and meta-analysis

Haiyan Jiang1,2,*, Yunyi Su1,†, Ruixue Liu1, Xinyi Xu1, Qi Xu1, Jie Yang3, Yapeng Lin1,4

1School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan Province, China
2Department of Rheumatology and Immunology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan Province, China
3Department of Neurology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China
4Department of Neurology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan Province, China

Keywords: Cohort study, hyperuricemia, meta-analysis, stroke.

Abstract

Objectives: The relationship between hyperuricemia (HUA) and stroke remains controversial. In this systematic review, we discuss the association between HUA and stroke.

Materials and methods: The PubMed, Embase, Web of Science, and Cochrane Library were searched from their earliest records to March 13th, 2024, and additional papers were identified through a manual search. Prospective studies that provided a multivariate-adjusted estimate of the association between HUA and risk of stroke incidence and mortality, represented as relative risks (RRs) with 95% confidence intervals (CIs), were eligible.

Results: A total of 22 studies including 770,532 adults were eligible and included. Hyperuricemia was associated with a significantly increasing risk of both stroke incidence (pooled RR, 1.42; 95% CI, 1.31-1.53) and stroke mortality (pooled RR, 1.53; 95% CI, 1.18-1.99) in our meta-analyses. Relative risk of stroke incidence was as follows: females (pooled RR, 1.67; 95% CI, 1.44-1.92) and males (pooled RR, 1.13; 95% CI, 1.02-1.25). Relative risk of mortality was as follows: female (pooled RR, 1.41; 95% CI, 1.31-1.52) and males (pooled RR, 1.27; 95% CI, 1.20-1.34). For the risk of stroke mortality, the association between HUA and ischemic stroke (pooled RR, 1.39; 95% CI, 1.31-1.47) was more significant than that of hemorrhagic stroke (pooled RR, 1.13; 95% CI, 1.02-1.26).

Conclusion: Our study confirms an association between HUA and risk of stroke, which is more pronounced in females.

* These authors contributed equally to this work.

Citation: Jiang H, Su Y, Liu R, Xu X, Xu Q, Yang J, et al. Hyperuricemia and the risk of stroke incidence and mortality: A systematic review and meta-analysis. Arch Rheumatol 2025;40(1):128-143. doi: 10.46497/ ArchRheumatol.2025.10808.

Author Contributions

Idea, data collection: H.J., Y.S.; Design: Y.L.; Control: H.J., R.L.; Analysis: Q.X.; Literature review: X.X.; Writing the article: Y.S.; Critical review: H.J., Y.L.; References and fundings: H.J., J.Y.; Materials: X.X.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.