• Tain-Junn Cheng, How-Ran Guo, Chia-Yu Chang, Shih-Feng Weng, Pi-I Li, Jhi-Joung Wang, and Wen-Shiann Wu.
• From the Department of Neurology (T-JC, C-YC); Department of Occupational Medicine (T-JC), Chi Mei Medical Center, Yongkang; Department of Occupational Safety and Disaster Prevention (T-JC), College of Sustainable Environment, Chia Nan University of Pharmacy and Science, Jen-Te; Department of Environmental and Occupational Health (H-RG, P-IL), College of Medicine; Department of Occupational and Environmental Medicine (H-RG), National Cheng Kung University Hospital; Center for General Education (C-YC), Southern Taiwan University, Yongkang, Tainan; Department of Healthcare Administration and Medical Informatics (S-FW), Kaohsiung Medical University, Kaohsiung; Department of Family Medicine (P-IL); Department of Medical Research (J-JW); Department of Internal Medicine (W-SW), Chi Mei Medical Center; and Department of Pharmacy (W-SW), Chia Nan University of Pharmacy and Science, Jen-Te, Tainan, Taiwan.
• Medicine (Baltimore). 2016 May 1; 95 (22): e3797e3797.

AbstractStroke is a common cause of death worldwide, but about 30% of ischemic stroke (IS) patients have no identifiable contributing risk factors. Because peptic ulcer disease (PUD) and vascular events share some common risk factors, we conducted a population-based study to evaluate the association between PUD and IS.We followed up a representative sample of 1 million residents of Taiwan using the National Health Insurance Research Database from 1997 to 2011. We defined patients who received medications for PUD and had related diagnosis codes as the PUD group, and a reference group matched by age and sex was sampled from those who did not have PUD. We also collected data on medical history and monthly income. The events of IS occurred after enrollment were compared between the 2 groups. The data were analyzed using Cox proportional hazard models at the 2-tailed significant level of 0.05.The PUD group had higher income and prevalence of hypertension, diabetes mellitus (DM), heart disease, and hyperlipidemia. They also had a higher risk of developing IS with an adjusted hazard ratio of 1.31 (95% confidence interval: 1.20-1.41). Other independent risk factors included male sex, older age, lower income, and co-morbidity of hypertension, diabetes mellitus (DM), and heart disease.PUD is a risk factor for IS, independent of conventional risk factors such as male sex, older age, lower income, and co-morbidity of hypertension, DM, and heart disease. Prevention strategies taking into account PUD should be developed and evaluated.

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