Male or Female; Young or Old--Smokers have Same Stroke Risk: Global Study.

Jojy Cheriyan MD;MPH-August 22, 2013.

This is the first largest study to be sex-specific on a global basis, analyzing a globally pooled data, of 4 million participants and 42,400 strokes. It has been unknown whether the high risk of stroke by smoking is the same for men and women. Previous studies have reported that smoking is an independent risk factor for stroke, generally, in both sexes.

There is enormous evidence by previous studies that women who smoke have higher chance for lung cancer and heart attacks.

But, this new study published today (August 22,2013) by the Journal STROKE of American Heart/Stroke Association is the first of its kind to be sex specific and also to some extent, region specific. The authors gathered data through a review of population-based cohort studies published from 1966 to 2013 and included a study pool of 81 prospective cohorts from around the world. By region, the total study population was comprised of 31% participants from Asian countries, 62% from the U.S., 4% from Europe, and 3% from Australia or New Zealand.

The researchers found that stroke is the same among male and female smokers around the globe when compared to non-smokers, regardless of age. However, by global region, there was a significantly greater smoking-related stroke risk seen in Western women than Western men (Relative Risk Ratio(RRR) 1.10, 95% CI 1.02-1.18) and no difference seen between Asian women and men (RRR 0.97, 95% CI 0.87-1.09).

Researchers also found that the risk of stroke is markedly decreased among previous smokers (who quit smoking) when compared to never-smokers. This also was the same for both sexes, regardless of age.

According to the researchers this study has several limitations like difference in the number of cigarettes smoked per day which may differ by sex; also underreporting of smoking habits in women of some ethnic groups, duration of smoking etc.

But the findings like excess risk of stroke for smokers and reduction of risk by quitting smoking add up to the existing evidence. Also women in western region smoke more than men, and that could be the reason for high risk of stroke among women-smokers in those regions.

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