The Association of Smoking and Cardiovascular Disease in a Population With Low Cholesterol Levels

Lawlor, Debbie A.; Song, Yun-Mi; Sung, Joohon; Ebrahim, Shah; Smith, George Davey

doi:10.1161/strokeaha.107.494823

Cited by 34 publications

(29 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a number of previous studies, including several from this population, 20,25,27 these risk factors have tended to have similar associations with IS and MI but different associations with IHS, lending support to the hypothesis that IS and MI share much of their etiology, but IHS differs in its etiology and pathophysiology. 31 Interestingly, in this study we found that the associations with FBG were stronger for IS than for MI, and indeed the association with MI was more similar to that for IHS.…”

Section: Sung Et Al Glucose Stroke and Myocardial Infarction 817supporting

confidence: 57%

Fasting Blood Glucose and the Risk of Stroke and Myocardial Infarction

et al. 2009

Self Cite

View full text Add to dashboard Cite

Background-Although diabetes is a well-known risk factor of atherosclerotic cardiovascular diseases, the cardiovascular disease risk of glycemia below the current diabetic threshold remains uncertain. Methods and Results-A total of 652 901 Korean men aged 30 to 64 years from the Korean National Health Insurance System were categorized into 8 groups by fasting blood glucose (FBG) level at baseline and were followed up for cardiovascular diseases occurrence during 1992-2001. Over the follow-up period of 8.8 years, 10 954 stroke and 3766 myocardial infarction events occurred. In age-adjusted analyses, there was evidence of linear associations between FBG and myocardial infarction, ischemic stroke, and intracerebral hemorrhagic stroke. However, with additional adjustment for socioeconomic position, behaviors, and other cardiovascular disease risk factors, the associations with myocardial infarction and intracerebral hemorrhagic stroke were markedly attenuated with increased risk only at the highest FBG levels (Ն7.5 mmol/L). With full adjustment, the association with ischemic stroke persisted; a linear increase in the risk of ischemic stroke was observed from FBG level of 5.6 mmol/L. When the analyses were repeated with those persons who had been diagnosed with diabetes removed, there was no evidence of associations of FBG with intracerebral hemorrhagic stroke, but the association with ischemic stroke persisted. Conclusions-In this Korean male population, the association with high FBG differed between ischemic stroke, intracerebral hemorrhagic stroke, and myocardial infarction. The linear increase in the risk of ischemic stroke, independently of other cardiovascular risk factors, was observed at a level below the current FBG criteria for impaired fasting glucose (Ն5.6 mmol/L). However, for other cardiovascular diseases, the current cutoff for diagnosing diabetes appropriately identified Korean men at risk.

show abstract

Section: Sung Et Al Glucose Stroke and Myocardial Infarction 817supporting

confidence: 57%

Fasting Blood Glucose and the Risk of Stroke and Myocardial Infarction

et al. 2009

Self Cite

View full text Add to dashboard Cite

show abstract

“…Multivariable-adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for the development of stroke subtypes and myocardial infarction according to smoking status in Korean men aged 30 to 64 years enrolled in the Korean National Health System Prospective Cohort Study. 43 HRs were adjusted for age, height, blood pressure, body mass index, total cholesterol, hyperglycemia, alcohol consumption, regular exercise, income, and area of residence. Never smoking was used as the reference group.…”

Section: Hypercholesterolemiamentioning

confidence: 99%

“…In the Korean National Health System Prospective Cohort Study, 43 the association of smoking with the development of CVD was assessed using a large-scale cohort consisting of 648,346 Korean men with a 10-year follow-up. As shown in Figure 7, there were strong linear trends of increased risk of ischemic stroke, subarachnoid hemorrhage, and MI with greater number of cigarettes smoked per day.…”

Section: Smokingmentioning

confidence: 99%

Epidemiology of Stroke and Coronary Artery Disease in Asia

Hata

Kiyohara

2013

Circ J

162

View full text Add to dashboard Cite

Stroke and coronary artery disease (CAD) are major causes of death throughout the world. As half of the world's population lives in Asian countries, prevention of stroke and CAD in Asia is crucial. According to the vital statistics, East Asian countries have a lower mortality rate for CAD than for stroke. In contrast, CAD is a more common cause of death than stroke in other Asian countries and Western countries. Hypertension, diabetes, hypercholesterolemia, and smoking are major risk factors for stroke and CAD in Asia as well as in Western countries. In an observational study in Japan, the stroke incidence decreased as a result of improvements in blood pressure control and reduction in the smoking rate over the past half century, whereas the CAD incidence did not show a clear secular change, probably because the benefits of blood pressure control and smoking cessation were negated by increasing prevalence of both glucose intolerance and hypercholesterolemia. Although Asian populations have lower serum cholesterol levels than Western populations, the prevalence of hypercholesterolemia has increased during the past half century in Asia. In addition, the smoking rate among Asian men is higher than for Western men. These results underscore that, in addition to blood pressure control, smoking cessation and the management of metabolic risk factors are very important for prevention of stroke and CAD in Asia. (Circ J 2013; 77: 1923 -1932

show abstract

“…A dose-response relationship exists between cigarette smoking and stroke risk. Smoking is a modifiable risk factor and cessation of smoking reduces the risk of stroke and other outcomes after several years of quitting [73]. In a cohort study of women, the stroke and cardiovascular mortality reached a comparable risk to never smokers after 20 years of cessation [74].…”

Section: Smokingmentioning

confidence: 99%

Treatment of Risk Factors to Prevent Stroke

Aoki

Uchino

2011

Neurotherapeutics

View full text Add to dashboard Cite

Much of the decline in stroke incidence and mortality for the past several decades in Western countries has been attributed to better treatment of risk factors. Many epidemiological studies and clinical trials confirmed the importance of managing hypertension. Comparative trials of anti-hypertensive drugs or drug classes have not yielded clear results, but blood pressure variability may play an important role beyond the absolute value of blood pressure. Diabetes therapy remains a conundrum. Although diabetes is clearly a risk factor for ischemic stroke, treatment trials targeting different glycemic goals have not indicated that glucose lowering results in stroke prevention. Trials focused on insulin resistance are ongoing and they may be able to help establish the management of diabetes/impaired glucose tolerance. Evidence for treatment of dyslipidemia has contrasted science to diabetes mellitus. Dyslipidemia has not been strongly or consistently linked to ischemic stroke but the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial showed the impact of statin treatment in stroke prevention. The results of clinical trials investigating dabigatran and rivaroxaban clearly indicate alternative strategies to vitamin K antagonists in stroke prevention for persons with atrial fibrillation. Evidence for stroke prevention by life style modification, treating metabolic syndrome, sleep disordered breathing, lipoprotein (a), hyperhomocysteinemia, and coagulation disorders are also discussed.

show abstract

The Association of Smoking and Cardiovascular Disease in a Population With Low Cholesterol Levels

Cited by 34 publications

References 24 publications

Fasting Blood Glucose and the Risk of Stroke and Myocardial Infarction

Fasting Blood Glucose and the Risk of Stroke and Myocardial Infarction

Epidemiology of Stroke and Coronary Artery Disease in Asia

Treatment of Risk Factors to Prevent Stroke

Contact Info

Product

Resources

About