This study aims to explore the correlation between rheumatoid arthritis (RA) and stroke risk in the adult population of the United States, utilizing data resources from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2023.

We analyzed 36,360 participants in the NHANES database, including 1, 677 RA patients. Demographic characteristics and baseline characteristics were presented using descriptive statistics, and complex sample weights were used to estimate population characteristics, body mass index (BMI), and the overall incidence of diabetes, hypertension, and arthritis. Subsequently, in the multivariate linear regression model, covariates with statistical significance were included for analysis, with RA as the predictor variable and stroke as the outcome variable, calculating the effect size (β) and its 95% confidence interval (CI).

The study found that compared to non-RA individuals, RA patients had a higher risk of stroke (OR=3.183, 95% CI: (2.493, 4.064), P<0.001). After adjusting for potential confounding factors, the positive correlation between RA and stroke still existed (OR=1.599, 95% CI: (1.209, 2.114), P=0.004). Subgroup analysis showed that the risk of stroke increased in female RA patients (OR=1.605, 95%CI: (1.128, 2.282), P=0.008); RA patients under the age of 60 had a more significant increase in stroke risk (OR=2.686, 95% CI: (1.679, 4.299), P<0.001).

The results of the study reveal a significant association between RA and stroke risk, highlighting the importance of stroke prevention and management in RA patients. These findings provide a new perspective for clinical decision-making and offer a scientific basis for the formulation of future public health policies.