Gallstone disease and the risk of stroke: a nationwide population-based study

J Stroke Cerebrovasc Dis. 2014 Aug;23(7):1813-20. doi: 10.1016/j.jstrokecerebrovasdis.2014.04.024. Epub 2014 Jun 21.


Background: Gallstone disease (GD) and stroke share a number of risk factors including diabetes and hyperlipidemia. This nationwide population-based study was designed to estimate the risk of stroke after a diagnosis of GD.

Methods: Data were obtained from the Taiwan National Health Insurance Research Database. A total of 135,512 patients with a diagnosis of GD and 271,024 age- and gender-matched non-GD control patients were included to assess the risk of stroke using Cox proportional hazard regression.

Results: During the study period (2000-2003), 12,234 (153.67/10,000 person-years) strokes occurred among the GD patients, and 20,680 (114.83/10,000 person-years) among the controls. The diagnosis of GD carried a higher risk of developing ischemic and hemorrhagic stroke, with a hazard ratio (HR) of 1.28 and 1.33 (95% confidence interval [CI], 1.25-1.31 and 1.25-1.41, both P < .0001), respectively. Stroke risk was increased in both genders but at a higher rate in younger age. The GD group had significantly higher prevalence rate of comorbidities that are known stroke risk factors, including hypertension, diabetes, and coronary artery disease. Stroke risk was higher in the GD group with or without any of these comorbidities.

Conclusions: In this population-based longitudinal follow-up study, GD carried a significantly higher stroke risk, particularly for younger age with or without stroke risk factors. Stroke preventive measures maybe needed for patients with GD, especially those of younger age and with stroke risk factor(s).

Keywords: Stroke; cholelithiasis; epidemiology; gallstone disease; risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cohort Studies
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Gallstones / complications*
  • Gallstones / epidemiology
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Population
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Stroke / complications*
  • Stroke / epidemiology
  • Taiwan / epidemiology