Risk factors for stroke in type 2 diabetes mellitus - United Kingdom prospective diabetes study (UKPDS) 29

Objective: To investigate modifiable and nonmodifiable risk factors for str oke in type 2 diabetes mellitus. Patients and Methods: A total of 3776 patients aged 25 to 65 years newly di agnosed as having type 2 diabetes mellitus without known cardiovascular or other serious disease were studied for a median of 7.9 years. An initial st epwise evaluation of risk factors was done in 2704 patients with all risk f actors measured, with the final Cox model analysis being of 3776 patients w ho had complete data on the selected variables. Results: Of 3776 patients, 99 (2.6%) had a stroke. Significant risk factors for stroke in a multivariate model were age (estimated hazard ratio [95% c onfidence interval], 4.78 [2.56-8.92] for greater than or equal to 60 vs <5 0 years), male sex (1.63 [1.08-2.47)] vs female), hypertension (2.47 [1.64- 3.74)] vs normotension), and in 3728 patients who had electrocardiography a t study entry, atrial fibrillation (8.05 [3.52-18.44] vs sinus rhythm). Obe sity, lack of exercise, smoking, poor glycemic control, hyperinsulinemia, d yslipidemia, and microalbuminuria were not significantly associated with st roke in the model. Conclusion: In patients with type 2 diabetes, aggressive antihypertensive t herapy and routine anticoagulation therapy for atrial fibrillation may redu ce the risk of stroke.