PMID- 16282538
OWN - NLM
STAT- MEDLINE
DCOM- 20051222
LR  - 20220318
IS  - 1524-4628 (Electronic)
IS  - 0039-2499 (Linking)
VI  - 36
IP  - 12
DP  - 2005 Dec
TI  - The impact of history of hypertension and type 2 diabetes at baseline on the 
      incidence of stroke and stroke mortality.
PG  - 2538-43
AB  - BACKGROUND AND PURPOSE: Both hypertension and diabetes are strong predictors of 
      stroke, but very few studies have assessed their joint effect on stroke risk. We 
      evaluated prospectively the joint association of history of hypertension and type 
      2 diabetes on the incidence of stroke and stroke mortality. METHODS: We 
      prospectively followed 49,582 Finnish subjects aged 25 to 74 years without a 
      history of stroke and coronary heart disease at baseline. Hazards ratios (HRs) 
      for stroke risk were estimated by the hypertension and diabetes status. RESULTS: 
      During a mean follow-up of 19.1 years, 2978 incident stroke events were recorded, 
      of which 924 were fatal. Age-, sex-, and study year-adjusted HRs of stroke 
      incidence were 1.35 (95% CI, 1.21 to 1.51), 1.98 (95% CI, 1.79 to 2.19), 2.54 
      (95% CI, 1.61 to 4.01), 3.51 (95% CI, 2.40 to 5.14), and 4.50 (95% CI, 3.60 to 
      5.61), respectively, among subjects with hypertension I (blood pressure 140 to 
      159/90 to 94 mm Hg) only, with hypertension II (blood pressure > or =160/95 mm 
      Hg, or using antihypertensive drugs) only, with diabetes only, with both 
      hypertension I and diabetes, and with both hypertension II and diabetes compared 
      with the subjects without either of the diseases. The corresponding HRs of stroke 
      mortality were 1.47, 2.62, 3.06, 5.59, and 9.27, respectively. Additional 
      adjustments for body mass index, cholesterol, education, smoking, alcohol 
      consumption, and physical activity did not appreciably change these risk 
      estimates. Blood pressure affected the risk of stroke similarly in diabetic and 
      nondiabetic subjects. CONCLUSIONS: Hypertension and type 2 diabetes increase 
      stroke risk independently, and their combination increases the risk drastically. 
      A significant proportion of the risk of stroke assumed to be related to 
      hypertension may be attributable to concomitant diabetes.
FAU - Hu, Gang
AU  - Hu G
AD  - Department of Epidemiology and Health Promotion, National Public Health 
      Institute, Helsinki, Finland. hu.gang@ktl.fi
FAU - Sarti, Cinzia
AU  - Sarti C
FAU - Jousilahti, Pekka
AU  - Jousilahti P
FAU - Peltonen, Markku
AU  - Peltonen M
FAU - Qiao, Qing
AU  - Qiao Q
FAU - Antikainen, Riitta
AU  - Antikainen R
FAU - Tuomilehto, Jaakko
AU  - Tuomilehto J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20051110
PL  - United States
TA  - Stroke
JT  - Stroke
JID - 0235266
SB  - IM
CIN - Stroke. 2006 May;37(5):1150; author reply 1150. PMID: 16556874
MH  - Adult
MH  - Aged
MH  - Comorbidity
MH  - Diabetes Mellitus, Type 2/*epidemiology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertension/classification/*epidemiology
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Population Surveillance
MH  - Prospective Studies
MH  - Risk Factors
MH  - Stroke/classification/*mortality
MH  - Survival Rate
EDAT- 2005/11/12 09:00
MHDA- 2005/12/24 09:00
CRDT- 2005/11/12 09:00
PHST- 2005/11/12 09:00 [pubmed]
PHST- 2005/12/24 09:00 [medline]
PHST- 2005/11/12 09:00 [entrez]
AID - 01.STR.0000190894.30964.75 [pii]
AID - 10.1161/01.STR.0000190894.30964.75 [doi]
PST - ppublish
SO  - Stroke. 2005 Dec;36(12):2538-43. doi: 10.1161/01.STR.0000190894.30964.75. Epub 
      2005 Nov 10.