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Duration of Cigarette Smoking and Hypertension Are More Powerful Than Serum Lipid Levels

Timothy J. Ingall, MBBS, PhD; Daniel Homer, MD; Hillier L. Baker, Jr, MD; Bruce A. Kottke, MD, PhD; W. Michael O'Fallon, PhD; Jack P. Whisnant, MD

Arch Neurol. 1991;48(7):687-691.

Abstract
• The effect of cigarette smoking on intracranial internal carotid artery atherosclerosis (ICAS) was studied by obtaining cigarette smoking histories and data on other potential predictors, including serum lipid estimations, for consecutive patients undergoing carotid arteriography. The duration of cigarette smoking was the most significant independent predictor of the presence of ICAS. Other independently significant predictors of ICAS were hypertension, diabetes mellitus, and current systolic blood pressure. The interaction of diabetes and duration of smoking was a significant negative predictor. In patients for whom serum lipid values were available, lower levels of apolipoprotein A-I were associated with a higher risk of having ICAS. However, the effect of apolipoprotein A-I as a predictor of the presence of ICAS was far outweighed by the effects of duration of smoking and hypertension.

Author Affiliations
From the Departments of Health Sciences Research (Drs Ingall, O'Fallon, and Whisnant), Neurology (Drs Homer and Whisnant), Diagnostic Radiology (Dr Baker), and the Division of Cardiovascular Diseases and Internal Medicine (Dr Kottke), Mayo Clinic and Mayo Foundation, Rochester, Minn.

Footnotes
Accepted for publication January 31, 1991.

Reprint requests to Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Dr Whisnant).

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