Cigarette Smoking and Incident Stroke in Blacks of the Jackson Heart Study

Author:

Oshunbade Adebamike A.1,Yimer Wondwosen K.2,Valle Karen A.2,Clark Donald1,Kamimura Daisuke13,White Wendy B.4,DeFilippis Andrew P.5,Blaha Michael J.6,Benjamin Emelia J.78,O'Brien Emily C.9,Mentz Robert J.9,Fox Ervin R.1,O'Mara Charles S.10,Butler Javed1,Correa Adolfo1,Hall Michael E.1

Affiliation:

1. Division of Cardiology Department of Medicine University of Mississippi Medical Center Jackson MS

2. Department of Data Sciences University of Mississippi Medical Center Jackson MS

3. Department of Medical Science and Cardiorenal Medicine Yokohama City University Graduate School of Medicine Yokohama Japan

4. Tougaloo College Jackson MS

5. Division of Cardiovascular Medicine University of Louisville KY

6. Johns Hopkins Ciccarone Center for Prevention of Heart Disease Baltimore MD

7. Department of Medicine Boston University School of Medicine Boston MA

8. Department of Epidemiology Boston University School of Public Health Boston MA

9. Duke University Medical Center Duke Clinical Research Institute Durham NC

10. Division of Vascular Surgery Department of Surgery University of Mississippi Medical Center Jackson MS

Abstract

Background Blacks are disproportionately affected by stroke compared with whites; however, less is known about the relationship between stroke and cigarette smoking in blacks. Therefore, we evaluated the relationship between cigarette smoking and all incident stroke in the JHS (Jackson Heart Study). Methods and Results JHS participants without a history of stroke (n=4410) were classified by self‐reported baseline smoking status into current, past (smoked at least 400 cigarettes/life), or never smokers at baseline (2000–2004). Current smokers were further classified by smoking intensity (number of cigarettes smoked per day [1–19 and ≥20]) and followed up for incident stroke (through 2015). Hazard ratios (HRs) for incident stroke for current and past smoking compared with never smoking were estimated with adjusted Cox proportional hazard regression models. After adjusting for cardiovascular risk factors, the risk for stroke in current smokers was significantly higher compared with never smokers (HR, 2.48; 95% CI, 1.60–3.83) but there was no significant difference between past smokers and never smokers (HR, 1.10; 95% CI, 0.74–1.64). There was a dose‐dependent increased risk of stroke with smoking intensity (HR, 2.28 [95% CI, 1.38–3.86] and HR, 2.78 [95% CI, 1.47–5.28] for current smokers smoking 1–19 and ≥20 cigarettes/day, respectively). Conclusions In a large cohort of blacks, current cigarette smoking was associated with a dose‐dependent higher risk of all stroke. In addition, past smokers did not have a significantly increased risk of all stroke compared with never smokers, which suggests that smoking cessation may have potential benefits in reducing the incidence of stroke in blacks.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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