Table 3.5Studies on the association between smoking and the presence of subclinical cardiovascular disease using brain magnetic resonance imaging

StudyDesign/populationAge/genderMain resultsComments
Breteler et al. 1994Rotterdam Elderly Study
Community-based
Cross-sectional
Netherlands
n = 111
65–84 years
Both genders
No association was observed between the presence of WMLs* and current or former smoking after adjusting for age and genderNo substantial change in the results was found after further adjustments for a previous stroke and myocardial infarction
Longstreth et al. 1996CHS
Community-based
Cross-sectional
United States
n = 3,301
≥65 years
Both genders
In analyses adjusted for age and gender, ever smoking cigarettes (p <0.001) and more pack-years of smoking (p <0.05) were associated with WML gradeNone
Yamashita et al. 1996Cross-sectional
Japan
n = 246
50–75 years
Men
Cigarette smoking was not related to silent brain infarctionsNo adjustments were mentioned
Liao et al. 1997ARIC§ Study
Cross-sectional
Community-based
United States
n = 1,920
51–70 years
Both genders
Age, race, and gender were adjusted proportionally by WML gradeLinear trend was statistically significant (p = 0.004)
WML grade
NormalMildModerateSevere
0123–9
Smoking status
 Current smokers12.345.024.518.2
 Former smokers13.452.522.911.3
 Never smoked16.549.822.710.9
Howard et al. 1998bARIC Study
Community-based
Cross-sectional
United States
n = 1,737
55–72 years
Both genders
Odds ratios (OR) for silent cerebral infarctions:Cigarette smoking had a significant ordinal association (p = 0.029); other risk factors included demographics, cerebrovascular disease risk factors (HDLΔ, triglycerides, hypertension, and diabetes), and lifestyle factors (fat and alcohol intake, BMI, and physical activity)
OROR when adjusted for other risk factors
Smoking status
 Nonsmokers11
 Smokers exposed to environmental tobacco smoke1.031.06
 Former smokers1.321.16
 Current smokers2.131.88
Longstreth et al. 1998CHS
Community-based
Cross-sectional
United States
n = 3,660
≥65 years
Both genders
In analyses adjusted for age and gender, pack-years were associated with silent lacunar infarcts (p <0.05)None
Shintani et al. 1998Hospital-based
Cross-sectional
Japan
n = 270
40–87 years
Both genders
There was no association between silent lacunar infarctions and smoking habits with or without adjusting for other main risk factors (serum levels or total cholesterol, HDL cholesterol, triglycerides, lipoprotein(a), hemoglobin A1c, age, gender, systolic blood pressure, diastolic blood pressure, duration of hypertension, family history, alcohol intake, obesity [BMI], and atrial fibrillation)None
*

WML = White matter lesion.

CHS = Cardiovascular Health Study.

Pack-years = The number of years of smoking multiplied by the number of packs of cigarettes smoked per day.

§

ARIC = Atherosclerosis risk in communities.

Δ

HDL = High-density lipoprotein.

BMI = Body mass index.

From: 3, Cardiovascular Diseases

Cover of The Health Consequences of Smoking
The Health Consequences of Smoking: A Report of the Surgeon General.
Office of the Surgeon General (US); Office on Smoking and Health (US).

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