User login
SAN DIEGO—Each year of diabetes duration is linked with a 3% increase in ischemic stroke risk, according to research presented at the 136th Annual Meeting of the American Neurological Association. After 10 years of diabetes duration, the risk for ischemic stroke increases threefold, researchers reported.
“Duration of diabetes is independently associated with ischemic stroke,” reported Julio R. Vieira, MD, from the Department of Neurology at Columbia University in New York City, and colleagues. “There is a duration threshold effect at 10 or more years. The risk triples in those with diabetes for 10 or more years.”
The Northern Manhattan Study
Dr. Vieira and colleagues enrolled 3,298 participants (mean age, 69) from the Northern Manhattan Study; all participants were stroke-free at baseline. Diabetes and age at diagnosis were determined, and participants were assessed annually for incident diabetes.
Twenty-two percent of the study population was diabetic at baseline, and 11% developed new-onset diabetes during the follow-up period. “Diabetes at baseline was associated with ischemic stroke (adjusted hazard ratio, 2.5),” the investigators reported. “The magnitude was similar when analyzed as a time-varying covariate (adjusted hazard ratio, 2.4).”
When Dr. Vieira’s team conducted a time-dependent analysis, they found that the duration of diabetes was significantly associated with ischemic stroke, with the risk increasing 3% per year for each year of diabetes that a patient had.
The investigators’ findings confirmed their hypothesis that stroke risk increases with longer disease duration: “Compared to nondiabetics, those with diabetes for 0 to five years (adjusted hazard ratio, 1.7), five to 10 years (adjusted hazard ratio, 1.8), and 10 or more years (adjusted hazard ratio, 3.3) were at increased risk,” Dr. Vieira and colleagues noted.
Linking Diabetes Duration and Stroke
“Several potential mechanisms could explain the association of diabetes duration and stroke in our study,” co-investigator Mitchell S. V. Elkind, MD, Associate Professor of Neurology and Epidemiology in the Department of Neurology at Columbia University, told Neurology Reviews. “There is evidence of an association between diabetes duration and atherosclerotic lesions, including intimal medial thickness and thin cap fibroatheromas.
“In addition, hypertension is twice as prevalent among diabetics as in people without diabetes, and long-term hypertension causes accelerated microvascular and macrovascular complications among diabetics,” Dr. Elkind noted. He also cited endothelial dysfunction and abnormalities in fibrinogen and clotting mechanisms as other potential mediators of this relationship.
“More people are developing diabetes, and at earlier ages; thus there are people living with diabetes for longer periods of time,” Dr. Elkind commented. “The effect of diabetes on stroke risk is not an all-or-nothing effect; the risk increases with time of having diabetes…. We need to delay the onset of diabetes as much as possible.”
Suggested Reading
Boden-Albala B, Cammack S, Chong J, et al. Diabetes, fasting glucose levels, and risk of ischemic stroke and vascular events: findings from the Northern Manhattan Study. Diabetes Care. 200;31(6):1132-1137.
Murakami Y, Huxley RR, Lam TH, et al. Diabetes, body mass index and the excess risk of coronary heart disease, ischemic and hemorrhagic stroke in the Asia Pacific Cohort Studies Collaboration. Prev Med. 2011 October 28; [Epub ahead of print].
Rundek T, Gardener H, Xu Q, et al. Insulin resistance and risk of ischemic stroke among nondiabetic individuals from the northern Manhattan study. Arch Neurol. 2010;67(10):1195-1200.
Vieira JR, Elkind MS, Moon YP, et al. The metabolic syndrome and cognitive performance: the Northern Manhattan Study. Neuroepidemiology. 2011;37(3-4):153-159.
SAN DIEGO—Each year of diabetes duration is linked with a 3% increase in ischemic stroke risk, according to research presented at the 136th Annual Meeting of the American Neurological Association. After 10 years of diabetes duration, the risk for ischemic stroke increases threefold, researchers reported.
“Duration of diabetes is independently associated with ischemic stroke,” reported Julio R. Vieira, MD, from the Department of Neurology at Columbia University in New York City, and colleagues. “There is a duration threshold effect at 10 or more years. The risk triples in those with diabetes for 10 or more years.”
The Northern Manhattan Study
Dr. Vieira and colleagues enrolled 3,298 participants (mean age, 69) from the Northern Manhattan Study; all participants were stroke-free at baseline. Diabetes and age at diagnosis were determined, and participants were assessed annually for incident diabetes.
Twenty-two percent of the study population was diabetic at baseline, and 11% developed new-onset diabetes during the follow-up period. “Diabetes at baseline was associated with ischemic stroke (adjusted hazard ratio, 2.5),” the investigators reported. “The magnitude was similar when analyzed as a time-varying covariate (adjusted hazard ratio, 2.4).”
When Dr. Vieira’s team conducted a time-dependent analysis, they found that the duration of diabetes was significantly associated with ischemic stroke, with the risk increasing 3% per year for each year of diabetes that a patient had.
The investigators’ findings confirmed their hypothesis that stroke risk increases with longer disease duration: “Compared to nondiabetics, those with diabetes for 0 to five years (adjusted hazard ratio, 1.7), five to 10 years (adjusted hazard ratio, 1.8), and 10 or more years (adjusted hazard ratio, 3.3) were at increased risk,” Dr. Vieira and colleagues noted.
Linking Diabetes Duration and Stroke
“Several potential mechanisms could explain the association of diabetes duration and stroke in our study,” co-investigator Mitchell S. V. Elkind, MD, Associate Professor of Neurology and Epidemiology in the Department of Neurology at Columbia University, told Neurology Reviews. “There is evidence of an association between diabetes duration and atherosclerotic lesions, including intimal medial thickness and thin cap fibroatheromas.
“In addition, hypertension is twice as prevalent among diabetics as in people without diabetes, and long-term hypertension causes accelerated microvascular and macrovascular complications among diabetics,” Dr. Elkind noted. He also cited endothelial dysfunction and abnormalities in fibrinogen and clotting mechanisms as other potential mediators of this relationship.
“More people are developing diabetes, and at earlier ages; thus there are people living with diabetes for longer periods of time,” Dr. Elkind commented. “The effect of diabetes on stroke risk is not an all-or-nothing effect; the risk increases with time of having diabetes…. We need to delay the onset of diabetes as much as possible.”
SAN DIEGO—Each year of diabetes duration is linked with a 3% increase in ischemic stroke risk, according to research presented at the 136th Annual Meeting of the American Neurological Association. After 10 years of diabetes duration, the risk for ischemic stroke increases threefold, researchers reported.
“Duration of diabetes is independently associated with ischemic stroke,” reported Julio R. Vieira, MD, from the Department of Neurology at Columbia University in New York City, and colleagues. “There is a duration threshold effect at 10 or more years. The risk triples in those with diabetes for 10 or more years.”
The Northern Manhattan Study
Dr. Vieira and colleagues enrolled 3,298 participants (mean age, 69) from the Northern Manhattan Study; all participants were stroke-free at baseline. Diabetes and age at diagnosis were determined, and participants were assessed annually for incident diabetes.
Twenty-two percent of the study population was diabetic at baseline, and 11% developed new-onset diabetes during the follow-up period. “Diabetes at baseline was associated with ischemic stroke (adjusted hazard ratio, 2.5),” the investigators reported. “The magnitude was similar when analyzed as a time-varying covariate (adjusted hazard ratio, 2.4).”
When Dr. Vieira’s team conducted a time-dependent analysis, they found that the duration of diabetes was significantly associated with ischemic stroke, with the risk increasing 3% per year for each year of diabetes that a patient had.
The investigators’ findings confirmed their hypothesis that stroke risk increases with longer disease duration: “Compared to nondiabetics, those with diabetes for 0 to five years (adjusted hazard ratio, 1.7), five to 10 years (adjusted hazard ratio, 1.8), and 10 or more years (adjusted hazard ratio, 3.3) were at increased risk,” Dr. Vieira and colleagues noted.
Linking Diabetes Duration and Stroke
“Several potential mechanisms could explain the association of diabetes duration and stroke in our study,” co-investigator Mitchell S. V. Elkind, MD, Associate Professor of Neurology and Epidemiology in the Department of Neurology at Columbia University, told Neurology Reviews. “There is evidence of an association between diabetes duration and atherosclerotic lesions, including intimal medial thickness and thin cap fibroatheromas.
“In addition, hypertension is twice as prevalent among diabetics as in people without diabetes, and long-term hypertension causes accelerated microvascular and macrovascular complications among diabetics,” Dr. Elkind noted. He also cited endothelial dysfunction and abnormalities in fibrinogen and clotting mechanisms as other potential mediators of this relationship.
“More people are developing diabetes, and at earlier ages; thus there are people living with diabetes for longer periods of time,” Dr. Elkind commented. “The effect of diabetes on stroke risk is not an all-or-nothing effect; the risk increases with time of having diabetes…. We need to delay the onset of diabetes as much as possible.”
Suggested Reading
Boden-Albala B, Cammack S, Chong J, et al. Diabetes, fasting glucose levels, and risk of ischemic stroke and vascular events: findings from the Northern Manhattan Study. Diabetes Care. 200;31(6):1132-1137.
Murakami Y, Huxley RR, Lam TH, et al. Diabetes, body mass index and the excess risk of coronary heart disease, ischemic and hemorrhagic stroke in the Asia Pacific Cohort Studies Collaboration. Prev Med. 2011 October 28; [Epub ahead of print].
Rundek T, Gardener H, Xu Q, et al. Insulin resistance and risk of ischemic stroke among nondiabetic individuals from the northern Manhattan study. Arch Neurol. 2010;67(10):1195-1200.
Vieira JR, Elkind MS, Moon YP, et al. The metabolic syndrome and cognitive performance: the Northern Manhattan Study. Neuroepidemiology. 2011;37(3-4):153-159.
Suggested Reading
Boden-Albala B, Cammack S, Chong J, et al. Diabetes, fasting glucose levels, and risk of ischemic stroke and vascular events: findings from the Northern Manhattan Study. Diabetes Care. 200;31(6):1132-1137.
Murakami Y, Huxley RR, Lam TH, et al. Diabetes, body mass index and the excess risk of coronary heart disease, ischemic and hemorrhagic stroke in the Asia Pacific Cohort Studies Collaboration. Prev Med. 2011 October 28; [Epub ahead of print].
Rundek T, Gardener H, Xu Q, et al. Insulin resistance and risk of ischemic stroke among nondiabetic individuals from the northern Manhattan study. Arch Neurol. 2010;67(10):1195-1200.
Vieira JR, Elkind MS, Moon YP, et al. The metabolic syndrome and cognitive performance: the Northern Manhattan Study. Neuroepidemiology. 2011;37(3-4):153-159.