Smoking as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 81 cohorts, including 3 980 359 individuals and 42 401 strokes

Peters, Sanne A. E., Huxley, Rachel R. and Woodward, Mark (2013) Smoking as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 81 cohorts, including 3 980 359 individuals and 42 401 strokes. Stroke, 44 10: 2821-2828. doi:10.1161/STROKEAHA.113.002342


Author Peters, Sanne A. E.
Huxley, Rachel R.
Woodward, Mark
Title Smoking as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 81 cohorts, including 3 980 359 individuals and 42 401 strokes
Journal name Stroke   Check publisher's open access policy
ISSN 0039-2499
1524-4628
Publication date 2013-01-01
Year available 2013
Sub-type Article (original research)
DOI 10.1161/STROKEAHA.113.002342
Open Access Status Not Open Access
Volume 44
Issue 10
Start page 2821
End page 2828
Total pages 8
Place of publication Philadelphia, PA United States
Publisher Lippincott Williams and Wilkins
Language eng
Subject 2705 Cardiology and Cardiovascular Medicine
2728 Clinical Neurology
2902 Advanced and Specialised Nursing
Abstract Background and Purpose-It is currently unknown whether the excess risk of stroke by smoking is the same for women and men. We performed a systematic review and meta-analysis to estimate the effect of smoking on stroke in women compared with men. Methods-PubMed MEDLINE was systematically searched for prospective population-based cohort studies published between January 1, 1966, and January 26, 2013. Studies that presented sex-specific estimates of the relative risk of stroke comparing current smoking with nonsmoking and its associated variability were selected. The sex-specific relative risks and their ratio (RRR), comparing women with men, were pooled using random-effects meta-analysis with inverse variance weighting. Similarly, the RRR for former versus never smoking was pooled. Results-Data from 81 prospective cohort studies that included 3 980 359 individuals and 42 401 strokes were available. Smoking was an independent risk factor for stroke in both sexes. Overall, the pooled multiple-adjusted RRR indicated a similar risk of stroke associated with smoking in women compared with men (RRR, 1.06 [95% confidence interval, 0.99-1.13]). In a regional analysis, there was evidence of a more harmful effect of smoking in women than in men in Western (RRR, 1.10 [1.02-1.18)] but not in Asian (RRR, 0.97 [0.87-1.09]) populations. Compared with never-smokers, the beneficial effects of quitting smoking among former smokers on stroke risk were similar between the sexes (RRR, 1.10 [0.99-1.22]). Conclusions-Compared with nonsmokers, the excess risk of stroke is at least as great among women who smoke compared with men who smoke.
Keyword Meta-analysis
Risk factors
Sex differences
Smoking
Stroke
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Public Health Publications
 
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