Cigarette smoking and other risk factors for silent cerebral infarction in the general population
Cigarette smoking and other risk factors for silent cerebral infarction in the general population
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DOI：
10.1161/01.str.29.5.913
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发表时间：
1998-05-01
期刊：
影响因子：
8.3
通讯作者：
Toole, JF
中科院分区：
文献类型：
--
作者：
Howard, G;Wagenknecht, LE;Toole, JF
背景和目的——无症状脑梗塞 (SCI) 在短暂性脑缺血发作人群中的患病率在 10% 到 40% 之间，并且与死亡率和发病率增加有关；然而，人们对普通人群中 SCI 的患病率和危险因素知之甚少。本报告重点关注吸烟和其他 SCI 危险因素在普通人群中的作用，作为社区动脉粥样硬化风险研究的一部分，对从普通人群中选出的 1737 名参与者进行了 MRI 扫描。评估吸烟状况和其他主要脑血管危险因素，并使用ANCOVA 建立吸烟状况与SCI 之间的关联。结果-总体而言，55 至70 岁人群中SCI 的患病率为11%。吸烟与 SCI 的存在存在有序关联 (P=0.029)，接触环境烟草烟雾的不吸烟参与者的比值比 (OR) 是未接触环境烟草烟雾的不吸烟参与者的 1.06（95% 置信区间 [CI]，0.64 至 1.75）倍；过去吸烟者的 OR 为 1.16（95% CI，0.74 至 1.83）倍，当前吸烟者的 OR 为 1.88（95% CI，1.13 至 3.13）倍。黑人、老年人和高血压参与者的患病率也有所增加。结论——本报告是第一份研究一般人群中 SCI 危险因素的报告，发现总体患病率相对较高 (11%)。吸烟和颈动脉粥样硬化之间的关系与吸烟和 SCI 的存在之间存在有序关系。与高血压和其他传统脑血管危险因素的影响相比，吸烟与吸烟的关联程度更大。当前吸烟者和既往吸烟者之间 SCI 患病率的降低，以及吸烟包年数增加与 SCI 患病率增加相关的趋势，都是避免吸烟和戒烟的额外论据。
Background and Purpose-Silent cerebral infarctions (SCIs) have a prevalence between 10% and 40% in the transient ischemic attack population and have been associated with increased mortality and morbidity; however, little is known about the prevalence and risk factors for SCI in the general population. This report focuses on the role of cigarette smoking and other risk factors for SCI in the general population,Methods-MRI scans were performed on 1737 participants selected from the general population as part of the Atherosclerosis Risk in Communities Study. Smoking status and other major cerebrovascular risk factors were assessed, and associations between smoking status and SCIs were established with the use of ANCOVA.Results-Overall, the prevalence of SCI in this population aged 55 to 70 years was 11%. Cigarette smoking had an ordered association (P=0.029) with the presence of SCI, with the odds ratio (OR) of nonsmoking participants exposed to environmental tobacco smoke being 1.06 (95% confidence interval [CI], 0.64 to 1.75) times as great as for nonsmokers not exposed; the OR of past smokers was 1.16 (95% CI, 0.74 to 1.83) times greater, and the OR of current smokers was 1.88 (95% CI, 1.13 to 3.13) times greater. An increased prevalence was also noted among black, older, and hypertensive participants.Conclusions-This report is among the first to examine the risk factors for SCI in the general population and finds a relatively high overall prevalence (11%). There is an ordered relationship between increasing exposure to cigarette smoke and the presence of SCI that parallels the relationship between smoking and carotid atherosclerosis. The magnitude of the association with smoking is substantial compared with the effect of hypertension and other traditional cerebrovascular risk factors. The reduction in prevalence of SCI between current and past smokers and the trend that increased pack-years of smoking is related to increased prevalence of SCI are both additional arguments for smoking avoidance and cessation.