Study Finds Increased Stroke Risk From High Blood Pressure And Diabetes May Peak At Middle Age


It should come as no surprise that type 2 diabetes and high blood pressure are two medical conditions that can raise the risk of stroke. However, a new study shows that these two chronic health issues may actually cause an even higher stroke risk to middle-aged adults as compared to older people.

According to lead study author and professor at the University of Alabama at Birmingham School of Public Health, George Howard, PhD,  “High blood pressure and diabetes are two important risk factors for stroke that can be managed by medication, decreasing a person’s risk.”

“Our findings show that their association with stroke risk may be substantially less at older ages, yet other risk factors do not change with age. These differences in risk factors imply that determining whether a person is at high risk for stroke may differ depending on their age,” Dr. Howard adds.


Following People With Diabetes and High Blood Pressure

The study, which was published in the January 18 copy of the journal Neurology, the researchers looked at data from 28,235 middle-aged and older adults that didn’t have a history of stroke. During the start of the study, the researchers asked the participants about a large range of possible risk factors of stroke, following up with them every six months for as long as 11 eleven years to see which of the participants had a stroke. They found that there was a total of 1,405 people that experienced a stroke during the duration of the study.

The risk factors that were analyzed during the study included high blood pressure, heart disease, smoking, type 2 diabetes, atrial fibrillation (an abnormal heartbeat), and another condition called ventricular hypertrophy, which is when there is a thickening of the heart’s left ventricle. This happens to be the chamber of the heart that pumps out oxygen-rich blood to the rest of the body.

Furthermore, researchers also looked at the role of race in the study since statistics show that Black adults usually have a higher risk of stroke than white adults. During the study, it was noted that ‘overall, 41 percent of the study participants were Black and 59 percent were white.’

Increased Stroke Risk Include Middle-Aged People With High Blood Pressure and Diabetes

During the study, some of the youngest participants in the study – aged 45 to 64 – were those with type 2 diabetes showed that they were ‘twice as likely to have a stroke during follow-up than people of the same age who didn’t have diabetes.’ Meanwhile, as for the older participants, those 75 years old and above, had an increased risk of stroke, while those with type 2 diabetes the association was only 30 percent.

At the same time, adults between the ages of 45 to 64 with high blood pressure ‘were 80 percent more likely to have a stroke during follow-up than adults without high blood pressure.’ However, among the older participants, those with high blood pressure only had an increased risk of stroke by just 50 percent.

As for the Black participants in the study, their race was associated with ‘a 34 percent higher stroke risk among middle-aged adults compared with white individuals in the same age group.’ However, the link between Black race and stroke also got lower with age.

Meanwhile, the researchers didn’t find an age-related change in the risk of stroke with the other risk factors, such as atrial fibrillation, smoking, and left ventricular hypertrophy.

The study authors did note that one limitation of the study was the they only managed to  assess stroke risk factors once throughout the study, when the participants joined. This means that there was a change that the participants’ health changed during the following 11 years in ways that managed to significantly impact their risk of having a stroke.

The Importance of Managing Blood Sugar and High Blood Pressure With Age

Dr. Howard also went on to say, “It is important to note that our results do not suggest that treatment of high blood pressure and diabetes becomes unimportant in older age.” He also shares that by managing those types of conditions using certain changes or treatments, such as medications or lifestyle changes to improve eating and exercise habits may still lessen the risk of stroke, while also improving one’s over health.

He adds, “But it also may be wise for doctors to focus on managing risk factors such as atrial fibrillation, smoking, and left ventricular hypertrophy as people age.”

Lifestyle Changes and Medications Can Help Lessen Stroke Risk 

According to medical director of the Foxhall Foundation and cardiologist at Johns Hopkins Medicine in Baltimore Joshua Yamamoto, MD, these findings should remind people that they need to be careful about their health and look out for ways to prevent strokes, regardless of their age, regardless of whether their blood sugar or blood pressure is okay.

Dr. Yamomoto, who was not part of the study, explains that this could simply mean using medication to help manage their type 2 diabetes or their high blood pressure. He says, “Modern medications can slow, and in some cases arrest, natural aging of the heart and arteries.”

Moreover, people can also look for ways to manage any chronic illnesses or health issues, such as high blood pressure or type 2 diabetes. This included making a number of lifestyle changes to minimize their stroke risk.

They can follow the guidelines of the U.S. Centers for Disease Control and Prevention (CDC), as stated below:

  • Pick healthy foods. Eat foods that are high in fiber and low in sodium, saturated fats, trans fats, and cholesterol.
  • Maintain a healthy weight. Obesity increases the risk of stroke.
  • Get enough exercise. Most adults need 150 minutes a week of moderate-intensity activity like a brisk walk. Check with your doctor before beginning a new fitness regimen.
  • Don’t smoke. Smoking cessation can reduce your stroke risk.
  • Limit alcohol. Drinking too much can raise your blood pressure.