title: Association of symptoms of chronic bronchitis and frequent flu-like illnesses with stroke.
abstract: OBJECTIVE
  Acute and several chronic infectious diseases increase the risk of stroke. We tested the hypothesis that chronic bronchitis and frequent flu-like illnesses are independently associated with the risk of stroke or transient ischemic attack (TIA).
  
  
  METHODS
  We assessed symptoms of chronic bronchitis, frequency of flu-like illnesses, and behavior during acute febrile infection in 370 consecutive patients with ischemic or hemorrhagic stroke or TIA and 370 age- and sex-matched control subjects randomly selected from the population.
  
  
  RESULTS
  Cough with phlegm during > or = 3 months per year (grade 2 symptoms of chronic bronchitis) was associated with stroke or TIA independent from smoking history, other risk factors, and school education (odds ratio [OR] 2.63, 95% confidence interval [CI] 1.17 to 5.94; P=0.021). There was also an independent association between frequent flu-like infections (>2 per yr) and stroke/TIA (OR 3.54; 95% CI 1.52 to 8.27; P=0.003). Simultaneous assessment of chronic bronchitis and frequent flu-like infections did not attenuate the effect of either factor. Patients reported more often than control subjects to continue to work despite febrile infection (OR 3.68, 95% CI 1.80 to 7.52, multivariate analysis).
  
  
  CONCLUSIONS
  Our results suggest that chronic bronchitis is among those chronic infections that increase the risk of stroke. Independent from chronic bronchitis, a high frequency of flu-like illnesses may also be a stroke risk factor. Infection-related behavior may differ between stroke patients and control subjects.
authors.affiliation: Department of Neurology, Klinikum der Stadt Ludwigshafen a.Rh., Germany. graua@klilu.de
authors.forename: Armin J
authors.initials: AJ
authors.lastname: Grau
authors.forename: Michael R
authors.initials: MR
authors.lastname: Preusch
authors.forename: Frederik
authors.initials: F
authors.lastname: Palm
authors.forename: Christoph
authors.initials: C
authors.lastname: Lichy
authors.forename: Heiko
authors.initials: H
authors.lastname: Becher
authors.forename: Florian
authors.initials: F
authors.lastname: Buggle
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D029481:Bronchitis, Chronic / Q000453:epidemiology*; D016022:Case-Control Studies; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D003371:Cough / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000453:epidemiology; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology*; D002546:Ischemic Attack, Transient / Q000453:epidemiology*; D008297:Male; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*