Similar stroke risk in adults with type 2 diabetes, healthy BP vs. general population
The overall risk for stroke is higher among adults with type 2 diabetes compared with those without diabetes, but those with type 2 diabetes and blood pressure less than 130/80 mm Hg have a similar risk for stroke as the general population, according to a study from Sweden.
Christina Hedén Ståhl, a PhD student in the department of molecular and clinical medicine, Institute of Medicine, University of Gothenburg in Sweden, and colleagues evaluated data from the Swedish National Diabetes Register 1998-2011 on 408,076 adults with type 2 diabetes without a history of stroke, as well as 1,913,507 age- and sex-matched controls without stroke from the general population. Researchers sought to determine the risk for stroke in people with diabetes with different BP levels compared with the risk in the general population. Follow-up was a median of 4 years.
More participants with diabetes received a diagnosis of stroke (4.8%) compared with those without diabetes (3.2%); 13.8% of strokes were fatal within 28 days. Participants with diabetes had higher incidence rates per 1,000 person-years for any stroke (diabetes, 10.63 vs. no diabetes, 6.8), ischemic stroke (9.62 vs. 5.92) and hemorrhagic stroke (1.01 vs. 0.88) compared with participants without diabetes.
The risk for stroke was significantly higher among participants with diabetes and BP of 130-139/80-89 mm Hg (HR = 1.2; 95% CI, 1.16-1.24), 140-159/90-99 mm Hg (HR = 1.47; 95% CI, 1.43-1.5) and at least 160/100 mm Hg (HR = 1.97; 95% CI, 1.9-2.03) compared with participants without diabetes.
The risk for ischemic stroke increased in participants with diabetes as BP increased, with the greatest risk among those with BP at least 160/100 mm Hg (HR = 2.02; 95% CI, 1.96-2.09).
Compared with participants without diabetes, the risk for hemorrhagic stroke was significantly lower among participants with diabetes and BP 120-129/70-79 mm Hg (HR = 0.66; 95% CI, 0.55-0.79) and 130-139/80-89 mm Hg (HR = 0.87; 95% CI, 0.78-0.97), whereas it was higher when BP was in the highest two categories (HR = 1.56; 95% CI, 1.41-1.73).
“People with type 2 diabetes as a group have a moderately elevated risk of stroke, which is higher for ischemic than for hemorrhagic stroke,” the researchers wrote. “Even so, individuals with type 2 diabetes and a BP < 130/80 mm Hg did not have a higher risk of any stroke compared with the general population. These findings further emphasize the importance of good BP control in people with type 2 diabetes and indicate that they can have a risk of any stroke that is similar to overall risk in the general population if BP is well controlled.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.