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Genetic risk, incident stroke, and the benefits of adhering to a healthy lifestyle: cohort study of 306 473 UK Biobank participants

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4168 (Published 24 October 2018) Cite this as: BMJ 2018;363:k4168

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Accounting for insulin treatment can improve the accuracy of stroke risk estimates.

A study by Rutten-Jacobs et al. [1] proposes a new approach to the problem and perhaps for the first time convincingly compares the genetic and modifiable aspects of the etiology of strokes.

However, such broad generalizations may not take into account the important features of certain categories of adults. For example, the authors presented data on the number of people with diabetes 12,927 (4.2%) and an increase in their stroke incidence (10.1% vs. 4.2 in “no stroke” category), tabl.1.

It should be noted that stroke frequency grows as the glucose lowering treatment of type 2 diabetes (T2D) is increased, reaching its maximum in insulin-treated T2D [2].

Accounting for insulin treatment can significantly improve the accuracy of stroke risk estimates. Perhaps the same can be said about treatment with statins.

1. BMJ 2018;363:k4168
2. M. Khalangot, G. Hu, M. Tronko, V. Kravchenko, V. Guryanov, Gender risk of nonfatal stroke in type 2 diabetic patients differs depending on the type of treatment, J. Women Health 18 (1) (2009) 97–103.

Competing interests: No competing interests

27 October 2018
Mykola D. Khalangot
MD
SHUPYK MEDICAL ACADEMY OF POSTGRADUATE EDUCATION
Dorohozhytska 9 Kyiv 04112 Ukraine