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For some time, I know we've been trying to figure out a way to resolve stuttering/frame pacing issues in Windows 10 (seems related to desktop composition, which gets disabled by eduke32 in Windows 7).

About a month ago, I tried to resolve this by calling dwmapi_DwmFlush() after calling SDL_GL_SwapWindow, and lo and behold, it worked very nicely. However, this has the effect of preventing the framerate from ever going above your refresh rate, regardless of the setting of r_maxfps.

I suggest giving this a try, and sending builds out to people experiencing frame stuttering, see if it works out.