Ischemic stroke risk elevated in patients with obsessive-compulsive disorder
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Patients with obsessive-compulsive disorder, or OCD, may have elevated risk for ischemic stroke compared with those without OCD, researchers reported.
“For decades, studies have found a relationship between stroke first and OCD later. Our findings remind clinicians to closely monitor blood pressure and lipid profiles, which are known to be related to stroke in patients with OCD. The results of our study should encourage people with OCD to maintain a healthy lifestyle, such as quitting or not smoking, getting regular physical activity and managing a healthy weight to avoid stroke-related risk factors,” Ya-Mei Bai, MD, PhD, a professor in the department of psychiatry at Taipei Veterans Hospital and National Yang Ming Chiao Tung University College of Medicine, Taiwan, said in a press release.
The researchers analyzed 28,064 patients (mean age, 37 years) with OCD from the Taiwan National Health Insurance Research Database and compared them with controls without OCD matched for age, sex and comorbidities. Follow-up was from enrollment to the end of 2011.
According to the researchers, patients with OCD had increased incidence of new-onset ischemic stroke (0.29% vs. 0.09%; P < .001), but not hemorrhagic stroke (0.08% vs. 0.05%; P = .188) compared with controls.
The researchers found that patients with OCD had higher Charlson comorbidity index scores (P < .001) and all-cause clinical visits (P < .001) compared with controls.
Patients with OCD had elevated risk for developing ischemic stroke during the follow-up period compared with controls (HR = 3.02; 95% CI, 1.91-4.77). The researchers found the difference was most pronounced in midlife adults (HR = 2.66; 95% CI, 1.34-5.29) and older adults (HR = 3.46; 95% CI, 1.7-7.05).
Hemorrhagic stroke risk did not differ between the OCD and non-OCD groups (HR = 0.87; 95% CI, 0.42-1.8), according to the researchers.
In models with death as a competing risk, OCD remained related to ischemic stroke (HR = 3.06; 95% CI, 1.93-4.84) but not hemorrhagic stroke (HR = 0.87; 95% CI, 0.42-1.82), Bai and colleagues found.
According to the researchers, among patients with OCD, both short-term use and long-term use of OCD medications were not related to risk for ischemic or hemorrhagic stroke compared with nonuse.
“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,” the researchers wrote.
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