Smoking as a Risk Factor for Stroke

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Abstract
Smoking has only more recently been established as one of the major risk factors for stroke. Numerous epidemiological studies have now established a close relationship between smoking and stroke as a whole and particularly for subgroups of cerebral ischaemia and subarachnoid haemorrhage. Whether smoking is a risk factor for primary intracerebral haemorrhage is not yet clearly established. The mechanism whereby smoking may exert these effects is by vessel wall changes (atherogenesis) and haematological effects and the relative impact of each of these mechanisms may vary depending of the age of the patient. Smoking may be a more potent risk factor in younger patients and in this group haematological effects may predominate. The duration of smoking may be more important than total dose and cessation of smoking may diminish but perhaps not abolish the risk of stroke. Much more evidence needs to be accumulated concerning the relationship between smoking and various stroke subgroups and a greater understanding is required concerning the specific mechanisms in each case. Information such as this is an important tool in public awareness campaigns which are needed to minimize one of the most potent but correctable risk factors for stroke.

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