Background
Elevated plasma uric acid has been inconsistently associated with a increased risk of total stroke; however, data are sparse among women. We examined the association between plasma uric acid concentrations and ischemic stroke among women and evaluate effect modification by key cardiovascular risk factors.
Methods
A nested case-control design with matching by age, race/ethnicity, smoking status, menopausal status, postmenopausal hormone therapy use, date of blood draw and fasting status was utilized among female participants of the Nurses' Health Study who provided blood samples between 1989-1990. Plasma uric acid was measured on stored blood samples. The National Survey of Stroke criteria were utilized to confirm 460 incident cases of ischemic stroke by medical records from 1990-2006. Multivariable conditional logistic regression models were estimated.
Results
In matched analysis, risk of ischemic stroke increased by 15% for each 1 mg/dL increase in plasma uric acid (95% CI: 3%-28%), but was no longer significant after adjustment for cardiovascular risk factors, particularly history of hypertension. The highest quartile of uric acid was significantly associated with greater risk of ischemic stroke (OR=1.56; 95% CI: 1.06-2.29, extreme quartiles) in matched analysis, but estimates were no longer significant after adjustment for cardiovascular risk factors (OR=1.43; 95% CI: 0.93-2.18). Significant effect modification by key cardiovascular risk factors was not observed.
Conclusions
Plasma uric acid levels were not independently associated with increased risk of ischemic stroke in this cohort of women. While plasma uric acid was associated with stroke risk factors, it was not independently associated with stroke risk.
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