Increased Risk of Ischemic Stroke Among Women With Bladder Pain Syndrome/Interstitial Cystitis:A Cohort Study From Taiwan
Shiu-Dong Chung,1,2 Sudha Xirasagar,3 Ching-Chun Lin,4 Wells Ling,5 Hsien-Chang Li,6 and Herng-Ching Lin2,6*
1Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei,Taiwan
2Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
3Arnold School of Public Health, Department of Health Services Policy and Management, University of South Carolina, Columbia, South Carolina
4Department of Psychology, Saint Louis University, St. Louis,Missouri
5Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan6School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
Aim: Vascular factors are proposed in the etiology of bladder pain syndrome/interstitial cystitis (BPS/IC). In this study, we investigated the risk of stroke among women following a diagnosis of BPS/IC over 3 years of follow-up, compared to controls without a BPS/IC diagnosis.
Methods: This retrospective cohort study used data retrieved from the Taiwan ‘‘Longitudinal Health Insurance Database 2000.’’ We identified 847 women who received a diagnosis of BPS/IC between January 1, 2001 and December 31, 2008 (study group) and 4,235 comparison women (women without a BPS/IC diagnosis matched on age and other selected demographic variables. All subjects were tracked for 3 years following the index date to identify those who received a diagnosis of stroke during follow-up.
Results: The stroke incidence rate was 20.86 (95% confidence interval (CI): 15.78–27.07) and 11.65 (95% CI: 9.88–13.64) per 1,000 person-years among the study and comparison cohorts, respectively. Cox regression analysis showed a stroke hazard ratio (HR) of 1.52 (95% CI: 1.09–2.14) in the BPS/IC group relative to the comparison group over 3-year follow-up, after adjusting for hypertension, diabetes, coronary heart disease, atrial fibrillation, hyperlipidemia, and chronic kidney disease. The adjusted HR of ischemic stroke was 1.52 (95% CI: 1.02–2.27). However, there was no significant difference between the two groups in hemorrhagic stroke risk.
Conclusions: Our study demonstrates an association between BPS/IC and a subsequent ischemic stroke diagnosis among women in Taiwan. Neurourol. Urodynam. 34:44–49, 2015. # 2013 Wiley Periodicals, Inc.