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

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...

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Main Authors: Peters, S., Huxley, Rachel, Woodward, M.
Format: Journal Article
Published: 2013
Online Access:http://hdl.handle.net/20.500.11937/27535
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author Peters, S.
Huxley, Rachel
Woodward, M.
author_facet Peters, S.
Huxley, Rachel
Woodward, M.
author_sort Peters, S.
building Curtin Institutional Repository
collection Online Access
description 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. © 2013 American Heart Association, Inc.
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spelling curtin-20.500.11937-275352017-09-13T15:08:24Z 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, S. Huxley, Rachel Woodward, M. 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. © 2013 American Heart Association, Inc. 2013 Journal Article http://hdl.handle.net/20.500.11937/27535 10.1161/STROKEAHA.113.002342 unknown
spellingShingle Peters, S.
Huxley, Rachel
Woodward, M.
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
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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
url http://hdl.handle.net/20.500.11937/27535