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Blood pressure and stroke risk among diabetic patients

Wenhui Zhao1, Peter T Katzmarzyk, Ronald Horswell

  • 1Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, Louisiana 70808, USA.

The Journal of Clinical Endocrinology and Metabolism
|May 30, 2013
PubMed

Insights

Extremely low or high blood pressure (BP) increases stroke risk in diabetic patients. Maintaining optimal BP levels is crucial for reducing stroke incidence in both African American and white populations.

Area of Science:

  • Cardiovascular Epidemiology
  • Nephrology
  • Public Health

Background:

  • Effective blood pressure (BP) control is vital for mitigating stroke risk in individuals with diabetes.
  • The optimal BP threshold for minimizing stroke risk in diabetic populations remains unclear.

Purpose of the Study:

  • To examine the association between various BP levels and stroke risk, specifically analyzing race-specific differences in diabetic patients.
  • To investigate the relationship between baseline and follow-up BP measurements and incident stroke risk.

Main Methods:

  • A prospective longitudinal study involving 17,536 African American and 12,618 white diabetic patients.
  • BP levels were categorized at baseline and stroke events were tracked over an average follow-up of 6.7 years.
  • Statistical analysis included multivariable adjustments to assess hazard ratios for stroke across different BP strata.

Main Results:

  • A U-shaped association was observed between BP levels and stroke risk in both African American and white diabetic patients.
  • Both very low BP (<110/65 mm Hg) and high BP (≥160/100 mm Hg) were linked to increased stroke risk.
  • This U-shaped pattern persisted regardless of antihypertensive medication use.

Conclusions:

  • The study indicates a U-shaped relationship between blood pressure and stroke risk in diabetic individuals.
  • Both aggressive BP reduction and uncontrolled high BP are associated with elevated stroke risk.
  • These findings highlight the importance of achieving and maintaining optimal BP targets in diabetic patient care.
Abstract

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