Smoking is Associated with Silent Cerebrovascular Disease in a High-Risk Japanese Community-Dwelling Population
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<B>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 A<SUB>1</SUB>c; 5) proteinuria; 6) high waist-to-hip ratio; 7) smoking ≥30 cigarettes/day; 8) heavy alcohol intake; 9) family history of stroke. The subjects with SCI (SCI group) were older (70 years <I>vs.</I> 66 years, <I>p</I> =0.004) and had higher systolic BP (SBP) (160 <I>vs.</I> 148 mmHg, <I>p</I> <0.001) and higher carotid plaque score (2.3 <I>vs.</I> 1.5/person, <I>p</I> <0.05) than those without SCI. Among the variables, smoking status (<I>r</I> =0.34, <I>p</I> <0.001), SBP (<I>r</I> =0.28, <I>p</I> <0.001), male gender (<I>r</I> =0.29, <I>p</I> <0.001), left ventricular mass index (<I>r</I> =0.25, <I>p</I> =0.001), and serum creatinine (<I>r</I> =0.20, <I>p</I> =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 <I>vs.</I> 0.5±0.8, <I>p</I> <0.01). In multiple regression analysis, smoking status (β =0.183, <I>p</I> =0.045) and SBP (β =0.196, <I>p</I> =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. (<I>Hypertens Res</I> 2004; 27: 747-754)</B>
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