Consistent Blood Pressure Control Cuts Stroke Risk in Diabetics and Non-Diabetics, Study Finds

"Diabetic patients who maintained their SBP within the desired range 75–100% of the time experienced a 36% lower stroke risk compared to those whose SBP was in range only 0–25% of the time (hazard ratio [HR] 0.64)," the researchers reported. "Among non-diabetic participants, stroke risk steadily decreased with higher time spent in the SBP target range, with those in the 50–75% and 75–100% brackets showing 25% and 38% reductions in stroke risk, respectively."

Published in Frontiers in Endocrinology, the prospective cohort study was led by Yuxin Yang and colleagues from the Department of Neurology at Shengjing Hospital of China Medical University, Shenyang, China. The research analyzed data from the Kailuan study to investigate how the proportion of time spent within the target systolic blood pressure range (SBP-TTR) influences stroke occurrence among people with and without diabetes.

The study enrolled 28,591 adults (average age 57.5 years, 83.8% male), of whom 23.2% had diabetes. Over a median follow-up of 8.7 years, 2,206 strokes were recorded. Researchers used Cox proportional hazards models to assess the association between SBP-TTR and stroke risk, stratifying participants by diabetic status.

The study revealed the following findings:

• Among people with diabetes, maintaining systolic blood pressure (SBP) in the target range 75–100% of the time significantly reduced stroke risk compared to those with only 0–25% time in range.
• Non-diabetic individuals also experienced stroke risk reductions at moderate SBP time in target range (50–75%), with even greater risk decline at 75–100% SBP-TTR.
• A significant interaction was found between diabetes status and SBP time in target range, indicating that the impact of blood pressure control on stroke risk varies depending on diabetes.
• Spline analysis revealed a non-linear relationship between SBP time in target range and stroke risk in diabetics.
• In contrast, a more linear association between SBP time in target range and stroke risk was observed in non-diabetic participants.

These findings highlight the crucial role of consistent blood pressure management in preventing stroke across populations. The protective effects of maintaining SBP within target ranges are clear for both diabetic and non-diabetic individuals but appear especially vital for those with diabetes who are at greater baseline cardiovascular risk.

The researchers emphasize the need for personalized hypertension management strategies that maximize the time patients spend within their ideal blood pressure ranges. Such tailored approaches could significantly reduce the incidence of stroke and improve long-term cardiovascular health outcomes.

The researchers note that future research will be essential to confirm these results and to explore the underlying mechanisms driving the differences in how blood pressure control impacts stroke risk in diabetic versus non-diabetic groups. Meanwhile, clinicians are encouraged to prioritize optimizing SBP-TTR in their patients to enhance stroke prevention efforts.

Reference:

Yang, Y., Wu, S., Zhang, J., Liu, Y., Yin, M., Huo, Z., Chen, S., Wang, G., Xiao, Y., Wang, Y., Li, Y., Deng, J., Geng, T., & Zhang, H. (2025). Time in target range for systolic blood pressure and stroke in people with and without diabetes: The Kailuan prospective cohort study. Frontiers in Endocrinology, 16, 1537343. https://doi.org/10.3389/fendo.2025.1537343