Severe Atopic Dermatitis Linked to Increased Risk of Ischemic Stroke, Finds Meta-Analysis
Brazil: A recent meta-analysis encompassing data from over 14.5 million individuals has revealed that people with atopic dermatitis (AD), especially those with more severe forms of the condition, face a significantly higher risk of stroke, primarily ischemic stroke. These findings highlight the need for heightened cardiovascular surveillance in this population.
Published in Clinical Neurology and Neurosurgery, the study was led by Luiz Carlos Figueiredo Filho and colleagues from the Faculty of Medicine, State University of Pará, Brazil. The researchers conducted a comprehensive review and meta-analysis to evaluate the association between AD—a chronic inflammatory skin disease—and the risk of stroke.
The team followed PRISMA guidelines and systematically searched major medical databases, including PubMed, Embase, Cochrane, and Scopus, among others. The analysis included 11 observational studies, primarily cohort studies, that investigated the incidence of stroke in individuals diagnosed with atopic dermatitis.
Based on the study, the researchers reported the following findings:
- Individuals with atopic dermatitis (AD) had a 27% higher overall risk of stroke.
- The stroke risk was higher in males with AD, with an odds ratio (OR) of 1.31.
- The strongest association was observed for ischemic stroke, with an OR of 1.14.
- No significant association was found between AD and hemorrhagic stroke, suggesting the elevated risk is specific to the ischemic subtype.
- The hazard ratio (HR) for ischemic stroke in people with AD was 1.19, with moderate heterogeneity (I² = 57%).
- For hemorrhagic stroke, the HR was 1.13, indicating the association was not statistically significant.
- Stroke risk increased with the severity of AD; individuals with severe AD had an OR of 1.29.
- Those with mild AD had a lower and non-significant stroke risk, with an OR of 1.06.
- The findings suggest that more severe skin inflammation in AD may contribute to a greater likelihood of cardiovascular complications.
Atopic dermatitis has long been recognized for its systemic inflammatory effects and its association with other comorbidities such as anxiety, depression, and cardiovascular diseases. This study reinforces those concerns by establishing a clear link between AD and ischemic stroke risk, particularly in individuals with severe disease.
The researchers emphasize the importance of proactive cardiovascular monitoring in patients with moderate to severe AD. They also call for further studies to explore whether effective treatment of atopic dermatitis could mitigate the associated stroke risk.
"In light of these findings, clinicians managing patients with AD—especially severe cases—may need to consider integrated care approaches that address both dermatologic and cardiovascular health," the researchers concluded.
Reference:
Figueiredo Filho, L. C., Massoud, R. O., Cabeça, R. A. S., Wanderley, I. J. M., Da Rocha, A. M., Aranha, M. F. D. A. C., Rosa, I. R., Cabeça, L. S., De Oliveira, R. D. C. S., & Monteiro, A. M. (2025). Relationship between patients with atopic dermatitis and the incidence of stroke: A systematic review with meta-analysis. Clinical Neurology and Neurosurgery, 253, 108888. https://doi.org/10.1016/j.clineuro.2025.108888
