Less Educated Smokers at Greatest Risk for Stroke
(HealthDay News) — Poorly educated adults who smoke face a higher stroke risk, as do those who smoke and have hypertension, according to a study published online August 14 in Stroke.
Helene Nordahl, PhD, from the University of Copenhagen in Denmark, and colleagues used additive hazard models to examine the combined effect of socioeconomics, smoking, and hypertension on stroke incidence among a pooled cohort of 68,643 men and women (aged 30–70 years).
The researchers found that those with low education had a higher prevalence of current smoking and hypertension. Low education was associated with greater ischemic, but not hemorrhagic, stroke incidence, compared to high education. Particularly among men, the combined effect of low education and current smoking was more than expected by the sum of their separate effects on ischemic stroke incidence, with 134 extra cases per 100,000 person-years because of the interaction (after adjustment for age, cohort study, and birth cohort). There was no association between low education and hypertension. Current smoking and hypertension's combined effect was more than expected by the sum of their separate effects on ischemic and hemorrhagic stroke incidence. Among women, this effect was most pronounced for ischemic stroke, with 178 extra cases per 100,000 person-years because of the interaction (after adjustment for age, cohort study, and birth cohort).
"Reducing smoking in those with low socioeconomic position and in those with hypertension could potentially reduce social inequality stroke incidence," the authors write.