Michiya Igase, Katsuhiko Kohara, Keiji Igase, Shiro Yamashita, Mutsuo Fujisawa, Ryosuke Katagi and Tetsuro Miki
Purpose: Aspirin is protective against ischemic stroke, but its use is a significant risk factor for gastro-esophageal reflux disease (GERD). We investigated the prevalence and associated clinical factors of GERD in ischemic stroke patients treated with aspirin.
Methods: We recruited 116 ischemic stroke outpatients who were receiving aspirin. Sixteen patients who had received proton pump inhibitors or H2 receptor antagonists within the previous month were excluded. The presence of GERD was defined using the GerdQ questionnaire, with a score of 8 or higher considered positive for GERD. Logistic regression analysis was conducted using variables which exhibited a significant correlation coefficient on two-group comparison as factors, with the presence or absence of GERD as the dependent variable.
Results: Mean age of the 100 patients analyzed was 69.3 ± 8.9 years. The prevalence of GERD was 28%. Mean BW of patients with GERD was significantly higher than of those without GERD (P =0.02). The proportion of patients receiving angiotensin II receptor blockers (ARBs) was significantly lower in the GERD group (P=0.04). In contrast, no significant difference was seen in the proportion of patients receiving calcium channel blockers (CCBs). Multivariable logistic regression analysis showed that ARB disuse and increased BW were independent predictors of GERD.
Conclusions: The prevalence of GERD was 28% in ischemic stroke patients treated with aspirin. Increased BW as well as ARBs disuse was independent risk factors of GERD. With all these factors, ARBs appear to be better suited than CCBs for use in patients with ischemic stroke with regard to the prevention of GERD. A comprehensive understanding of the relationship between ARBs and GERD prevalence awaits additional studies in a larger number
of patients.