Family History, Tobacco Smoking, and Risk of Ischemic Stroke

Abstract

Background and Purpose Both genetic factors and smoking are associated with ischemic stroke (IS) risk. However, little is known about the potential interaction of these factors. We aimed to assess whether smoking and a positive family history interact to increase the risk of IS. Methods The nationwide prospective study recruited 210,000 men and 300,000 women in 2004 to 2008 at ages 30 to 79 years. During 9.7 years of follow-up, we documented 16,923 and 20,656 incident IS cases in men and women without major chronic diseases at baseline, respectively. Multivariable Cox regression models were used to examine associations between family history and IS. Likelihood ratio tests were used to test the smoking-family history interactions on IS. Results About 67.8% (n=135,168) of men ever smoked regularly compared with 2.7% (n=7,775) of women. Among men, a significant interaction between family history and smoking on IS was observed ( P for interaction=0.03), with more pronounced association between family history and IS among ever-regular smokers (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.16 to 1.27) than among never-smokers (HR, 1.11; 95% CI, 1.01 to 1.23). The association between family history and IS among ex-smokers after more than 10 years of cessation (HR, 1.01; 95% CI, 0.85 to 1.20) appeared similar to that among never-smokers. Among women, a similar but not significant interaction between family history and smoking on IS was observed. Ever-regular smokers who had a family history of stroke had the highest risk of IS. Conclusions Among Chinese men, the association of family history with IS was accentuated by smoking, and such accentuation tended to be lowered by cessation.

A Prediction Model for Rapid Identification of Ischemic Stroke: Application of Serum Soluble Corin

“… 30 Family history of stroke, elevated fasting plasma glucose, and low cumulatively averaged HDL-C were associated with an increased IS risk. 31–33 In line with previous studies, our study shows that these risk factors are independent risk factors for ischemic stroke. All variables in our final prediction model are related to patient demographics and laboratory measurements, enabling the prediction of ischemic stroke risk using only clinical data.…”

Clopidogrel Resistance in Patients With Stroke Recurrence Under Single or Dual Antiplatelet Treatment

“…The rates of HPR and clopidogrel resistance were lower in current smokers. The authors believe that smoking is a major risk factor for ischemic stroke, and smoking cessation is necessary ( 21 – 24 ). However, we argue that it may be beneficial to consider the factors affecting HPR, such as smoking status, when selecting the SAPT agent for long-term secondary stroke prevention.…”

Tobacco smoking and solid fuels for cooking and risk of liver cancer: A prospective cohort study of 0.5 million Chinese adults

“…Among ever smokers, additional information on the age (years) of starting smoking on most days, the types of tobacco and quantity of daily (factory filter cigarettes, factory nonfilter cigarettes, handrolled cigarettes, cigars) or monthly (hand-rolled cigarettes, pipes or water pipes, liang per month, 1 liang equivalent to 50 g) consumption was collected. Equivalent number of daily cigarette consumption was calculated as (factory filter cigarettes + factory nonfilter cigarettes + 2 Â cigars + 5/3 Â hand-rolled cigarettes + 5/3 Â pipes or water pipes), by assuming a factory cigarette containing 1 g of tobacco and a cigar containing 2 g. 19 For ex-smokers, to avoid reverse causality bias, those who had stopped smoking because of illness were grouped with current smokers as per previous studies. 20 Participants were categorized according to smoking status (never smoker, ex-smoker and current smoker), number of cigarettes consumed per day (≤10, 11-20 and >20) and the age of starting regular smoking (>25, 19-25 and ≤18 years) among ever smokers.…”