ORIGINAL RESEARCH article

Front. Endocrinol.

Sec. Clinical Diabetes

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1537343

This article is part of the Research TopicAdvances in Diabetes and Hypertension ResearchView all 13 articles

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

Provisionally accepted
Yuxin YangYuxin Yang1Shouling WuShouling Wu2Jingdi ZhangJingdi Zhang3Yang LiuYang Liu4Mingjie YinMingjie Yin5Zhenyu HuoZhenyu Huo3Shuohua ChenShuohua Chen2Guodong WangGuodong Wang2Yao XiaoYao Xiao1Yue WangYue Wang1Yuanyuan LiYuanyuan Li1Jiawen DengJiawen Deng1Tingting GengTingting Geng6*Hong ZhangHong Zhang1*
  • 1Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
  • 2Kailuan General Hospital, Tangshan, Hebei Province, China
  • 3College of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, China
  • 4Peking University, Beijing, Beijing Municipality, China
  • 5Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei Province, China
  • 6Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hebei Province, China

The final, formatted version of the article will be published soon.

Select one of your emails

You have multiple emails registered with Frontiers:

Notify me on publication

Please enter your email address:

If you already have an account, please login

You don't have a Frontiers account ? You can register here

Objective: Systolic 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.We 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.Results: After 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).Higher 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.

Keywords: SBP-TTR & Stroke: Diabetics vs. Non-Diabetics diabetes, Kailuan study, Stroke, systolic blood pressure, time in target range

Received: 30 Nov 2024; Accepted: 22 Apr 2025.

Copyright: © 2025 Yang, Wu, Zhang, Liu, Yin, Huo, Chen, Wang, Xiao, Wang, Li, Deng, Geng and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Tingting Geng, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College Huazhong University of Science and Technology, Wuhan, 430030, Hebei Province, China
Hong Zhang, Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning Province, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material