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Diabetes increases lifetime risk for stroke in Japanese adults
In middle-aged Japanese men and women, diabetes status is associated with residual lifetime risk for stroke, according to findings from a population-based study.
“In our study, the [lifetime] risk for stroke was higher for the younger index ages (eg, age 40 years) compared to the older index ages (eg, age 55 years),” Tanvir Chowdhury Turin, MD, MSc, PhD, of the department of family medicine at the University of Calgary in Alberta, Canada, and colleagues wrote. “This phenomenon was observed for both participants with and without diabetes. This observation illustrates the need to initiate population-level stroke prevention activities early, especially among patients with diabetes, and provide support for efforts aimed at early identification and treatment of diabetes.”
Turin and colleagues analyzed data from 5,515 adults aged 30 to 79 years (2,596 men) who had not experienced stroke at baseline participating in the Suita study, a cohort study of cardiovascular diseases among urban residents in Japan. Between 1989 and 2007, participants attended clinical visits every 2 years and completed yearly questionnaires by mail or telephone. Age was used as the timescale; age-specific incidence rates were calculated using the person-years method within 5-year bands. Researchers estimated the sex- and index-age-specific lifetime risk of first-ever stroke, accounting for the competing risk for death.
During 71,371.23 person-years of follow-up, 137 men and 114 women experienced incident stroke, the majority experiencing cerebral infarction (n = 149).
At an index age of 40 years, the lifetime risk for stroke was 26.64% for men with diabetes vs. 15.98% for men without diabetes; lifetime risk for women with diabetes was 30.72% vs. 17.29% for women without diabetes. Results persisted after adjusting for competing risk of death. Lifetime risk was similar across index age categories (ages 45, 50 and 55 years) for both men and women.
Similar results were observed for cerebral infarction stroke subtype, according to researchers. After adjustment for competing risk of death, the lifetime risk for cerebral infarction at age 40 years was 21.09% for men with diabetes vs. 10.66% for men without diabetes; lifetime risk for women with diabetes was 18.16% vs. 7.89% for women without diabetes.
“The prospect of high [lifetime risk] might be more useful in encouraging younger individuals with low short-term risks to adjust their lifestyle through proper health education efforts intended at stroke prevention, thus reducing the population burden of stroke,” the researchers wrote. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
AUTHORS: Turin TC, Okamura T, Rumana N, Afzel R, Watanabe M, Higashiyama A, Nakao YM, Nakai M, Takegami M, Nishimura K, Kokubo Y, Okayama A, Miyamoto Y. BACKGROUND: Lifetime risk (LTR) is defined as the cumulative probability of developing a disease in one’s remaining lifetime from a given index age. The impact of diabetes on the LTR of stroke events in Asians, where stroke incidence is higher than for Westerners, has not been estimated yet. These estimates can be useful for diabetes knowledge translation activities ...