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SLE Tied to More Than Double Stroke Risk Across 25 CohortsPeople with lupus face significantly higher risk of stroke

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Key Takeaway
SLE is associated with a more than twofold increased risk of stroke, including both ischaemic and haemorrhagic subtypes.

A meta-analysis of 25 cohort studies, including over 5.2 million individuals, examined stroke risk in patients with systemic lupus erythematosus (SLE). The analysis found a significantly increased risk of stroke compared with individuals without SLE.

The overall relative risk (RR) for stroke was 2.60 (95% CI 2.21 to 3.05, p<0.001). For composite stroke, the RR was 2.83 (95% CI 2.25 to 3.57, p<0.001). Subtype analyses showed an RR of 2.34 for ischaemic stroke (95% CI 1.75 to 3.12, p<0.001) and 2.66 for haemorrhagic stroke (95% CI 1.57 to 4.49, p<0.001).

These findings indicate that SLE is associated with a more than twofold higher risk of stroke, with consistent elevations across stroke subtypes. The study is a meta-analysis of cohort studies, not a randomized controlled trial, so causality cannot be established.

Limitations include large heterogeneity across the included studies. Safety outcomes, follow-up duration, and funding sources were not reported. Clinicians should be aware of this association when managing cardiovascular risk in patients with SLE.

How this fits prior evidence

This meta-analysis confirms a significant association between systemic lupus erythematosus and increased stroke risk. While previous coverage noted that ivarmacitinib may offer clinical improvement in patients with alopecia areata and systemic lupus erythematosus, and that deep learning models show high sensitivity for SLE diagnosis, this study specifically quantifies the increased risk of stroke (RR 2.60) in the broader SLE population. It addresses a gap in quantifying the specific risk of ischaemic and haemorrhagic stroke subtypes in these patients.

Living with systemic lupus erythematosus (SLE) brings many daily challenges, but a new look at the data reveals a serious hidden risk. Researchers analyzed data from over 5 million people to see how the condition affects brain health. They found that people with lupus are much more likely to experience a stroke compared to those without the condition.

The data shows a significant increase in several types of stroke. This includes both ischemic strokes, which happen when blood flow is blocked, and hemorrhagic strokes, which happen when a blood vessel bursts. The numbers show that the risk for these events is more than double for those living with lupus.

While these findings are based on a very large group of people, the researchers noted that the studies they looked at were quite different from one another. This means the results show a clear link between lupus and stroke risk, but the exact reasons for this connection are still being explored.

What this means for you:
People with systemic lupus erythematosus have a significantly higher risk of experiencing various types of stroke.

Common questions

How much higher is the risk of stroke for people with lupus?

The study found that people with systemic lupus erythematosus have a much higher risk of stroke. Specifically, the risk for a composite stroke is 2.83 times higher. This includes both ischemic strokes, which have a risk of 2.34, and hemorrhagic strokes, which have a risk of 2.66.

What types of stroke are linked to lupus?

The research looked at several types of stroke. It found increased risks for composite stroke, ischemic stroke (caused by a blockage), and hemorrhagic stroke (caused by bleeding). All of these types showed a significant increase in risk for people with systemic lupus erythematosus.

How many people were included in this study?

The findings are based on a very large amount of data. The researchers looked at 5,220,837 individuals across 25 different cohort studies to determine the link between systemic lupus erythematosus and stroke risk.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
UNLABELLED: The association between SLE and composite stroke, ischaemic stroke and haemorrhagic stroke remains incompletely understood. This meta-analysis aims to assess the risk of stroke in patients with SLE. METHODS: Data sources included PubMed, Embase, the Cochrane Library and reference lists of included studies. This meta-analysis included cohort studies evaluating whether stroke risk is associated with SLE. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Risk ratios (RRs) with 95% CIs were pooled using a random-effects model, and publication bias was assessed with funnel plots and Egger's test. RESULTS: A total of 25 cohort studies involving 5 220 837 individuals were included in this meta-analysis, which were published between 2001 and 2026. The pooled analysis demonstrated a significantly increased risk of stroke in patients with SLE (RR of 2.60, 95% CI 2.21 to 3.05, ²=97.9%, p<0.001). The risk of composite stroke (RR of 2.83, 95% CI 2.25 to 3.57, ²=98.0%, p<0.001), ischaemic stroke (RR of 2.34, 95% CI 1.75 to 3.12, ²=97.6%, p<0.001) and haemorrhagic stroke (RR of 2.66, 95% CI 1.57 to 4.49, ²=96.2%, p<0.001) was also increased in SLE. Despite the large heterogeneity, the sensitivity analysis indicated that the results were robust, and there was little evidence of publication bias. CONCLUSION: The risk of composite stroke, ischaemic stroke and haemorrhagic stroke is increased in SLE. PROSPERO REGISTRATION NUMBER: CRD420261294082.
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