Cigarette Smoking and Stroke Risk in Young Women
Stroke risk was substantially higher in current smokers than in never smokers or former smokers and increased sharply with number of cigarettes smoked daily.
Although tobacco use is an important risk factor for cardiovascular diseases including stroke, data about smoking's contribution to stroke risk in young racially diverse women are lacking. Investigators analyzed data from the Stroke Prevention in Young Women Study to determine whether a dose–response
relation exists between tobacco use and incidence of ischemic stroke.
Women (age range, 15–49) hospitalized with first cerebral infarctions were identified based on discharge surveillance of 59 hospitals in the greater Baltimore–Washington DC area. Investigators analyzed interview data on smoking history in 466 women with stroke (cases) and 604 age-matched
controls with no history of stroke.
Compared with controls, cases were older; were more likely to be black; and had higher rates of hypertension, diabetes, coronary artery disease, and obesity. Adjusted analyses showed that current smokers were significantly more likely than never smokers to experience stroke (odds ratio, 2.6),
whereas former smokers and never smokers had similar stroke risk.
Importantly, ORs rose in relation to number of cigarettes smoked daily (OR, 2.2 for 1–10; 2.5 for 11–20; 4.3 for 21–39; and 9.1 for 40).
Comment: The results of this case-control study reveal a steep dose–response curve that links tobacco use to risk for ischemic stroke.
Although limited by its retrospective nature and by possible recall bias, this is one of the largest studies of early-onset stroke and its predictors in young women.
The dose–response relation shown here is more pronounced than any that have been reported in other populations. These data support aggressive campaigns to target tobacco use as a modifiable risk factor for stroke in young women.
— JoAnne M. Foody, MD
Published in Journal Watch Women's Health October 9, 2008