Dose-response Relationship Between Cigarette Smoking and Risk of Ischemic Stroke in Young Women

Overview

Journal Stroke

Specialties Cardiology & Vascular Diseases
Neurology

Date 2008 Aug 16

PMID 18703815

Citations 75

Authors

Viveca M Bhat

John W Cole

John D Sorkin

Marcella A Wozniak

Ann M Malarcher

Wayne H Giles

Barney J Stern

Steven J Kittner

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: Although cigarette smoking is known to be a risk factor for ischemic stroke, there are few data on the dose-response relationship between smoking and stroke risk in a young ethnically diverse population.

Methods: We used data from the Stroke Prevention in Young Women Study, a population-based case-control study of risk factors for ischemic stroke in women aged 15 to 49 years to examine the relationship between cigarette smoking and ischemic stroke. Historical data, including smoking history, was obtained through standardized interviews. Odds ratios (OR) were estimated using logistic regression. Cases (n=466) were women with stroke in the greater Baltimore-Washington area, and controls (n=604) were women free of a stroke history identified by random digit dialing.

Results: After multivariable adjustment, the OR comparing current smokers to never smokers was 2.6 (P<0.0001); no difference in stroke risk was observed between former smokers and never smokers. Adjusted OR increased with increasing number of cigarettes smoked per day (OR=2.2 for 1 to 10 cigs/d; 2.5 for 11 to 20 cigs/d; 4.3 for 21 to 39 cigs/d; 9.1 for 40 or more cigs/d).

Conclusions: These results suggest a strong dose-response relationship between cigarette smoking and ischemic stroke risk in young women and reinforce the need for aggressive smoking cessation efforts in young adults.

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References

Barua R, Ambrose J, Saha D, Eales-Reynolds L . Smoking is associated with altered endothelial-derived fibrinolytic and antithrombotic factors: an in vitro demonstration. Circulation. 2002; 106(8):905-8. DOI: 10.1161/01.cir.0000029091.61707.6b. View

You R, McNeil J, OMalley H, Davis S, Thrift A, Donnan G . Risk factors for stroke due to cerebral infarction in young adults. Stroke. 1997; 28(10):1913-8. DOI: 10.1161/01.str.28.10.1913. View

Doll R, Peto R, Boreham J, Sutherland I . Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004; 328(7455):1519. PMC: 437139. DOI: 10.1136/bmj.38142.554479.AE. View

Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, Larsson B, Welin L, Tibblin G . Fibrinogen as a risk factor for stroke and myocardial infarction. N Engl J Med. 1984; 311(8):501-5. DOI: 10.1056/NEJM198408233110804. View

Kittner S, STERN B, Wozniak M, Buchholz D, Earley C, Feeser B . Cerebral infarction in young adults: the Baltimore-Washington Cooperative Young Stroke Study. Neurology. 1998; 50(4):890-4. DOI: 10.1212/wnl.50.4.890. View

Colditz G, Bonita R, Stampfer M, Willett W, Rosner B, Speizer F . Cigarette smoking and risk of stroke in middle-aged women. N Engl J Med. 1988; 318(15):937-41. DOI: 10.1056/NEJM198804143181501. View

DOLL R, Peto R, Wheatley K, Gray R, Sutherland I . Mortality in relation to smoking: 40 years' observations on male British doctors. BMJ. 1994; 309(6959):901-11. PMC: 2541142. DOI: 10.1136/bmj.309.6959.901. View

Rohr J, Kittner S, Feeser B, Hebel J, Whyte M, Weinstein A . Traditional risk factors and ischemic stroke in young adults: the Baltimore-Washington Cooperative Young Stroke Study. Arch Neurol. 1996; 53(7):603-7. DOI: 10.1001/archneur.1996.00550070041010. View

Goldstein L, Adams R, Alberts M, Appel L, Brass L, Bushnell C . Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council: cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing.... Stroke. 2006; 37(6):1583-633. DOI: 10.1161/01.STR.0000223048.70103.F1. View

10.

Shinton R, Beevers G . Meta-analysis of relation between cigarette smoking and stroke. BMJ. 1989; 298(6676):789-94. PMC: 1836102. DOI: 10.1136/bmj.298.6676.789. View

11.

. Annual smoking-attributable mortality, years of potential life lost, and productivity losses--United States, 1997-2001. MMWR Morb Mortal Wkly Rep. 2005; 54(25):625-8. View

12.

Blann A, Kirkpatrick U, Devine C, Naser S, McCollum C . The influence of acute smoking on leucocytes, platelets and the endothelium. Atherosclerosis. 1998; 141(1):133-9. View

13.

Newby D, Wright R, Labinjoh C, Ludlam C, Fox K, Boon N . Endothelial dysfunction, impaired endogenous fibrinolysis, and cigarette smoking: a mechanism for arterial thrombosis and myocardial infarction. Circulation. 1999; 99(11):1411-5. DOI: 10.1161/01.cir.99.11.1411. View

14.

Nagy J, DeMaster E, Wittmann I, Shultz P, Raij L . Induction of endothelial cell injury by cigarette smoke. Endothelium. 1997; 5(4):251-63. DOI: 10.3109/10623329709052590. View

15.

Kawachi I, Colditz G, Stampfer M, Willett W, Manson J, Rosner B . Smoking cessation and decreased risk of stroke in women. JAMA. 1993; 269(2):232-6. View

16.

Renaud S, Blache D, Dumont E, Thevenon C, Wissendanger T . Platelet function after cigarette smoking in relation to nicotine and carbon monoxide. Clin Pharmacol Ther. 1984; 36(3):389-95. DOI: 10.1038/clpt.1984.193. View

17.

Robbins A, Manson J, Lee I, Satterfield S, Hennekens C . Cigarette smoking and stroke in a cohort of U.S. male physicians. Ann Intern Med. 1994; 120(6):458-62. DOI: 10.7326/0003-4819-120-6-199403150-00002. View

18.

Wolf P, DAgostino R, Kannel W, Bonita R, Belanger A . Cigarette smoking as a risk factor for stroke. The Framingham Study. JAMA. 1988; 259(7):1025-9. View

19.

Wannamethee S, Lowe G, Shaper A, Rumley A, Lennon L, Whincup P . Associations between cigarette smoking, pipe/cigar smoking, and smoking cessation, and haemostatic and inflammatory markers for cardiovascular disease. Eur Heart J. 2005; 26(17):1765-73. DOI: 10.1093/eurheartj/ehi183. View

20.

. From the Centers for Disease Control. Health benefits of smoking cessation. JAMA. 1990; 264(15):1930. View