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Smoking and the risk of hemorrhagic stroke in men.
Stroke 2003; 34(5):1151-5S

Abstract

BACKGROUND AND PURPOSE

Smoking is an established risk factor for ischemic stroke and subarachnoid hemorrhage (SAH), but the impact of smoking on intracerebral hemorrhage (ICH) is less clear.

METHODS

Prospective cohort study among 22,022 US male physicians participating in the Physicians' Health Study. Incidence of stroke was measured by self-report and confirmed by medical record review. We used Cox proportional-hazards models to evaluate the association of smoking with risk of total hemorrhagic stroke, ICH, and SAH. We categorized smoking into 4 groups: never, past, or current smokers of <20 or of >or=20 cigarettes per day.

RESULTS

During 17.8 years of follow-up, 108 ICHs and 31 SAHs occurred. Never smokers and past smokers had equal rates of ICH and SAH. Current smokers of <20 cigarettes per day had multivariable-adjusted relative risks of 1.65 (95% CI, 0.61 to 4.50) for total hemorrhagic stroke, 1.60 (95% CI, 0.50 to 5.07) for ICH, and 1.75 (95% CI, 0.24 to 13.09) for SAH when compared with never smokers. Current smokers of >or=20 cigarettes had relative risks of 2.36 (95% CI, 1.38 to 4.02) for total hemorrhagic stroke, 2.06 (95% CI, 1.08 to 3.96) for ICH, and 3.22 (95% CI, 1.26 to 8.18) for SAH when compared with never smokers.

CONCLUSIONS

This prospective study suggests an increased risk of total hemorrhagic stroke, ICH, and SAH in current cigarette smokers with a graded increase in risk that depended on how many cigarettes were smoked. The effect of smoking on ICH is of about the same magnitude as the effect of smoking on ischemic stroke. Our results add to the multiple health benefits that can be accrued by abstaining from cigarette smoking.

Authors+Show Affiliations

Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02215-1204, USA. tkurth@rics.bwh.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

12663877

Citation

Kurth, Tobias, et al. "Smoking and the Risk of Hemorrhagic Stroke in Men." Stroke, vol. 34, no. 5, 2003, pp. 1151-5.
Kurth T, Kase CS, Berger K, et al. Smoking and the risk of hemorrhagic stroke in men. Stroke. 2003;34(5):1151-5.
Kurth, T., Kase, C. S., Berger, K., Schaeffner, E. S., Buring, J. E., & Gaziano, J. M. (2003). Smoking and the risk of hemorrhagic stroke in men. Stroke, 34(5), pp. 1151-5.
Kurth T, et al. Smoking and the Risk of Hemorrhagic Stroke in Men. Stroke. 2003;34(5):1151-5. PubMed PMID: 12663877.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Smoking and the risk of hemorrhagic stroke in men. AU - Kurth,Tobias, AU - Kase,Carlos S, AU - Berger,Klaus, AU - Schaeffner,Elke S, AU - Buring,Julie E, AU - Gaziano,J Michael, Y1 - 2003/03/27/ PY - 2003/3/29/pubmed PY - 2003/7/2/medline PY - 2003/3/29/entrez SP - 1151 EP - 5 JF - Stroke JO - Stroke VL - 34 IS - 5 N2 - BACKGROUND AND PURPOSE: Smoking is an established risk factor for ischemic stroke and subarachnoid hemorrhage (SAH), but the impact of smoking on intracerebral hemorrhage (ICH) is less clear. METHODS: Prospective cohort study among 22,022 US male physicians participating in the Physicians' Health Study. Incidence of stroke was measured by self-report and confirmed by medical record review. We used Cox proportional-hazards models to evaluate the association of smoking with risk of total hemorrhagic stroke, ICH, and SAH. We categorized smoking into 4 groups: never, past, or current smokers of <20 or of >or=20 cigarettes per day. RESULTS: During 17.8 years of follow-up, 108 ICHs and 31 SAHs occurred. Never smokers and past smokers had equal rates of ICH and SAH. Current smokers of <20 cigarettes per day had multivariable-adjusted relative risks of 1.65 (95% CI, 0.61 to 4.50) for total hemorrhagic stroke, 1.60 (95% CI, 0.50 to 5.07) for ICH, and 1.75 (95% CI, 0.24 to 13.09) for SAH when compared with never smokers. Current smokers of >or=20 cigarettes had relative risks of 2.36 (95% CI, 1.38 to 4.02) for total hemorrhagic stroke, 2.06 (95% CI, 1.08 to 3.96) for ICH, and 3.22 (95% CI, 1.26 to 8.18) for SAH when compared with never smokers. CONCLUSIONS: This prospective study suggests an increased risk of total hemorrhagic stroke, ICH, and SAH in current cigarette smokers with a graded increase in risk that depended on how many cigarettes were smoked. The effect of smoking on ICH is of about the same magnitude as the effect of smoking on ischemic stroke. Our results add to the multiple health benefits that can be accrued by abstaining from cigarette smoking. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/12663877/Smoking_and_the_risk_of_hemorrhagic_stroke_in_men_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.STR.0000065200.93070.32?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -