Cigarette smoking. A risk factor for cerebral infarction in young adults
B. B. Love, J. Biller, M. P. Jones, H. P. Adams Jr and A. Bruno
Department of Neurology, University of Iowa College of Medicine, Iowa City.
To assess the impact of cigarette smoking on stroke in young adults (15 to
45 years old), we compared smoking data from 181 patients with cerebral
infarction with that of 307 control subjects matched for age, gender,
geographic location, and hospital admission dates. While controlling for
these matching variables and hypertension, an analysis based on a
conditional logistic regression model indicated that a smoker was 1.6 times
more likely to have a cerebral infarction than a non-smoker (95% confidence
interval, 1.07 to 2.42). There was a cumulative dose effect with each
additional pack-year causing a greater risk of having a cerebral
infarction. In fact, after adjusting for all other risk factors, there was
a significant quadratic component to the dose-response relationships, with
the result that individuals with a larger number of pack-years were
invariably the stroke patients. There was no significant difference in
smoking status among the various subtypes of cerebral infarction
(atherosclerotic, nonatherosclerotic vasculopathy, cardioembolic,
hematologic related, undetermined). These data indicate that cigarette
smoking is an important risk factor for cerebral infarction in young
adults. Risk factor modification through cessation of smoking may reduce
the risk of ischemic stroke in young adults.
