Early intensive multifactorial therapy reduces stroke risk

Gæde P, Oellgaard J, Kruuse C et al (2019) Beneficial impact of intensified multifactorial intervention on risk of stroke: outcome of 21 years of follow-up in the randomised Steno-2 Study. Diabetologia 62: 1575–80

• The Steno-2 Study demonstrated that intensified treatment of multiple cardiovascular disease risk factors significantly reduces cardiovascular events and microvascular complications and increases lifespan in people with type 2 diabetes.
• As the risk of stroke has increased over the past 30 years and is higher in people with diabetes, researchers performed a post-hoc analysis of the Steno-2 Study to determine the difference in time to first stroke event with standard versus intensive treatment.
• In Steno-2, 160 patients with type 2 diabetes and microalbuminuria were randomised to receive standard treatment or intensified multifactorial treatment (IMT) for an average of 7.8 years, at which point all were offered IMT and followed up for a further 13.4 years.
• IMT reduced the hazard for first stroke by 69% and the absolute risk of stroke by 15% during the follow-up period; 11% of individuals who initially received IMT and 26% of those who initially received standard care experienced at least one stroke. 
• There were significantly fewer recurrent strokes in the group initially randomised to IMT.
• The researchers concluded that IMT significantly reduced the risk of stroke and recurrent cerebrovascular events in individuals with type 2 diabetes and microalbuminuria.

Click here to access the article in full