title: Smoking is associated with silent cerebrovascular disease in a high-risk Japanese community-dwelling population.
abstract: We aimed to investigate the relationships between smoking and silent cerebrovascular damage. We performed brain MRI to evaluate silent cerebral infarct (SCI) and periventricular hyperintensity (PVH), and carotid-ultrasonography to investigate carotid atherosclerotic plaque in 170 high-risk community-dwelling subjects (mean age: 67.2 years; men: 28.7%) who met more than 3 of the following 9 criteria: 1) high blood pressure (BP); 2) hypercholesterolemia; 3) left ventricular hypertrophy; 4) high hemoglobin A1c; 5) proteinuria; 6) high waist-to-hip ratio; 7) smoking > or =30 cigarettes/day; 8) heavy alcohol intake; 9) family history of stroke. The subjects with SCI (SCI group) were older (70 years vs. 66 years, p=0.004) and had higher systolic BP (SBP) (160 vs. 148 mmHg, p <0.001) and higher carotid plaque score (2.3 vs. 1.5/person, p <0.05) than those without SCI. Among the variables, smoking status (r =0.34, p <0.001), SBP (r =0.28, p <0.001), male gender (r =0.29, p <0.001), left ventricular mass index (r =0.25, p =0.001), and serum creatinine (r =0.20, p =0.006) were significantly correlated with the number of SCIs. Among smokers, the number of SCIs was significantly higher in current smokers than in past smokers (1.9+/-2.2 vs. 0.5+/-0.8, p <0.01). In multiple regression analysis, smoking status (beta =0.183, p =0.045) and SBP (beta =0.196, p =0.011) were independent determinants of the increased number of SCIs. In conclusion, smoking status was an independent determinant of multiple SCIs in a high-risk Japanese community-dwelling population.
authors.affiliation: Department of Cardiology, Shioya General Hospital, Tochigi, Japan. kazuo-eg@jichi.ac.jp
authors.forename: Kazuo
authors.initials: K
authors.lastname: Eguchi
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hoshide
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hoshide
authors.forename: Joji
authors.initials: J
authors.lastname: Ishikawa
authors.forename: Masato
authors.initials: M
authors.lastname: Morinari
authors.forename: Toru
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Shimada
mesh_terms: D000368:Aged; D044466:Asian People; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging; D002544:Cerebral Infarction / Q000175:diagnosis / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000209:etiology*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications; D015994:Incidence; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D014463:Ultrasonography
chemical_list: D003404:Creatinine