Association Between HbA1c Levels and Stroke Risk Among Chronic Disease Program Participants: A Cross-Sectional Study

Background: Stroke remains a significant global public health concern and a major cause of hospital-based mortality. Diabetes mellitus (DM) is a modifiable risk factor, and HbA1c is an important indicator of glycemic control. However, limited evidence exists regarding the association between HbA1c levels and stroke risk among Program for Chronic Disease Management (Prolanis) participants in Indonesia. This study examined the association between HbA1c levels and stroke risk among Prolanis participants. Methods: This quantitative correlational study used total sampling and included 150 active Prolanis participants who had available HbA1c measurements. We collected data from May to July 2025 at three Community Health Centers (Puskesmas) in Blora Regency (Kunduran, Sonokidul, and Ngawen). Stroke risk was assessed using the Stroke Risk Score Card (SRSC) questionnaire, while HbA1c values were obtained from recorded laboratory results. The data were analyzed using the Spearman Rank correlation test. Results: Most respondents were female (67.3%) with a mean age of 62.43 years. All respondents had a history of DM, and 64% had hypertension. The mean HbA1c level was 8.4%, and 76% of respondents were categorized as having diabetes based on HbA1c results. Based on the SRSC, 66.7% were categorized as having a high risk of stroke. The Spearman Rank test showed a significant positive correlation between HbA1c levels and stroke risk (p = 0.005; r = 0.228). Conclusion: HbA1c levels were significantly associated with stroke risk among Prolanis participants. Regular stroke risk screening should be integrated into routine Prolanis care.