Time in target range for systolic blood pressure and stroke in people with and without diabetes: the Kailuan prospective cohort study

ObjectiveSystolic blood pressure time in target range (SBP-TTR) is an independent risk factor for stroke. We aimed to investigate the associations of SBP-TTR with stroke among participants with or without diabetes using data from the Kailuan study.MethodsWe included 28,591 participants [mean age, 57...

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Main Authors: Yuxin Yang, Shouling Wu, Jingdi Zhang, Yang Liu, Mingjie Yin, Zhenyu Huo, Shuohua Chen, Guodong Wang, Yao Xiao, Yue Wang, Yuanyuan Li, Jiawen Deng, Tingting Geng, Hong Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1537343/full
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author Yuxin Yang
Shouling Wu
Jingdi Zhang
Yang Liu
Mingjie Yin
Zhenyu Huo
Shuohua Chen
Guodong Wang
Yao Xiao
Yue Wang
Yuanyuan Li
Jiawen Deng
Tingting Geng
Hong Zhang
author_facet Yuxin Yang
Shouling Wu
Jingdi Zhang
Yang Liu
Mingjie Yin
Zhenyu Huo
Shuohua Chen
Guodong Wang
Yao Xiao
Yue Wang
Yuanyuan Li
Jiawen Deng
Tingting Geng
Hong Zhang
author_sort Yuxin Yang
collection DOAJ
description ObjectiveSystolic blood pressure time in target range (SBP-TTR) is an independent risk factor for stroke. We aimed to investigate the associations of SBP-TTR with stroke among participants with or without diabetes using data from the Kailuan study.MethodsWe included 28,591 participants [mean age, 57.5 years; 83.8% men; 23.2% with diabetes] from the Kailuan Study. Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of SBP-TTR on stroke in individuals with and without diabetes.ResultsAfter a median of 8.7 years follow-up, 2,206 stroke cases occurred. Among participants with diabetes, those with SBP-TTR 75%–100% (HR [95%CI]: 0.64 [0.49, 0.84]) had a lower risk of stroke compared to those with SBP-TTR 0%–25%. Among participants without diabetes, those with SBP-TTR 50%–75% (HR 0.75, 95% CI 0.64–0.88) and 75%–100% (HR [95%CI]: 0.62 [0.52, 0.73]) had a significantly lower risk of stroke. A significant interaction between diabetes status and SBP-TTR was observed (P for interaction = 0.03). Additionally, the restricted cubic spline analysis showed a non-linear relationship between SBP-TTR and stroke risk among participants with diabetes (P for non-linearity = 0.001), and a linear relationship among those without diabetes (P for non-linearity = 0.035).ConclusionHigher SBP-TTR was associated with a reduced risk of stroke among participants with or without diabetes. The findings underscore the importance of maintaining blood pressure within the target range to mitigate stroke risk, particularly emphasizing the need for stringent blood pressure control in diabetic patients.
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spelling doaj-art-1627e4205deb4f7db877e96f5ab5d5f72025-08-20T01:49:23ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-05-011610.3389/fendo.2025.15373431537343Time in target range for systolic blood pressure and stroke in people with and without diabetes: the Kailuan prospective cohort studyYuxin Yang0Shouling Wu1Jingdi Zhang2Yang Liu3Mingjie Yin4Zhenyu Huo5Shuohua Chen6Guodong Wang7Yao Xiao8Yue Wang9Yuanyuan Li10Jiawen Deng11Tingting Geng12Hong Zhang13Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Cardiology, Kailuan General Hospital, Tangshan, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, North China University of Science and Technology, Tangshan, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaDepartment of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, North China University of Science and Technology, Tangshan, ChinaDepartment of Cardiology, Kailuan General Hospital, Tangshan, ChinaDepartment of Cardiology, Kailuan General Hospital, Tangshan, ChinaDepartment of Neurology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Neurology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Neurology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Neurology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Neurology, Shengjing Hospital of China Medical University, Shenyang, ChinaObjectiveSystolic blood pressure time in target range (SBP-TTR) is an independent risk factor for stroke. We aimed to investigate the associations of SBP-TTR with stroke among participants with or without diabetes using data from the Kailuan study.MethodsWe included 28,591 participants [mean age, 57.5 years; 83.8% men; 23.2% with diabetes] from the Kailuan Study. Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of SBP-TTR on stroke in individuals with and without diabetes.ResultsAfter a median of 8.7 years follow-up, 2,206 stroke cases occurred. Among participants with diabetes, those with SBP-TTR 75%–100% (HR [95%CI]: 0.64 [0.49, 0.84]) had a lower risk of stroke compared to those with SBP-TTR 0%–25%. Among participants without diabetes, those with SBP-TTR 50%–75% (HR 0.75, 95% CI 0.64–0.88) and 75%–100% (HR [95%CI]: 0.62 [0.52, 0.73]) had a significantly lower risk of stroke. A significant interaction between diabetes status and SBP-TTR was observed (P for interaction = 0.03). Additionally, the restricted cubic spline analysis showed a non-linear relationship between SBP-TTR and stroke risk among participants with diabetes (P for non-linearity = 0.001), and a linear relationship among those without diabetes (P for non-linearity = 0.035).ConclusionHigher SBP-TTR was associated with a reduced risk of stroke among participants with or without diabetes. The findings underscore the importance of maintaining blood pressure within the target range to mitigate stroke risk, particularly emphasizing the need for stringent blood pressure control in diabetic patients.https://www.frontiersin.org/articles/10.3389/fendo.2025.1537343/fulldiabetesKailuan studystrokesystolic blood pressuretime in target range
spellingShingle Yuxin Yang
Shouling Wu
Jingdi Zhang
Yang Liu
Mingjie Yin
Zhenyu Huo
Shuohua Chen
Guodong Wang
Yao Xiao
Yue Wang
Yuanyuan Li
Jiawen Deng
Tingting Geng
Hong Zhang
Time in target range for systolic blood pressure and stroke in people with and without diabetes: the Kailuan prospective cohort study
Frontiers in Endocrinology
diabetes
Kailuan study
stroke
systolic blood pressure
time in target range
title Time in target range for systolic blood pressure and stroke in people with and without diabetes: the Kailuan prospective cohort study
title_full Time in target range for systolic blood pressure and stroke in people with and without diabetes: the Kailuan prospective cohort study
title_fullStr Time in target range for systolic blood pressure and stroke in people with and without diabetes: the Kailuan prospective cohort study
title_full_unstemmed Time in target range for systolic blood pressure and stroke in people with and without diabetes: the Kailuan prospective cohort study
title_short Time in target range for systolic blood pressure and stroke in people with and without diabetes: the Kailuan prospective cohort study
title_sort time in target range for systolic blood pressure and stroke in people with and without diabetes the kailuan prospective cohort study
topic diabetes
Kailuan study
stroke
systolic blood pressure
time in target range
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1537343/full
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