medwireNews: A Mendelian analysis supports a causal effect of hyperglycemia on stroke risk, and the researchers also pinpoint the medications most likely to reduce this risk.
“This underscores the importance of glycaemic control in reducing risk of stroke,” write Marianne Benn (Copenhagen University Hospital, Denmark) and co-researchers in Diabetologia.
Using data from 118,838 participants of two population-based studies, they found that each 1 mmol/L increase in genetically determined plasma glucose was associated with a significant 48% increase in the risk for stroke.
Combining this with summary-level data from the 440,328 participants of the MEGASTROKE study produced a 74% risk increase per 1 mmol/L increase in glucose.
The team also did a meta-analysis of 48 randomized controlled trials of antidiabetes medications that reported stroke as an outcome. This revealed that glucagon-like peptide (GLP)-1 receptor agonists and thiazolidinediones significantly reduced stroke risk, by 15% and 18%, respectively, but other medication classes had no significant effect.
“These findings are relevant since current ESC, EASD and ADA recommendations focus on acute coronary syndrome, heart failure and kidney disease, and do not include recommendations for individuals at a high risk of stroke,” says the team.
“Inclusion of ischaemic stroke in guidelines on treatment of diabetes and elevated plasma glucose may improve quality of patient diagnosis and care.”
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