Cigarette smoking, risk stroke

Reduction in risk of Ml, stroke, and death from cardiovascular causes - In patients 55 years of age or older at high risk of developing a major cardiovascular event because of a history of coronary artery disease, stroke, peripheral vascular disease, or diabetes that is accompanied by at least 1 other cardiovascular risk factor (eg, hypertension, elevated total cholesterol levels, low FIDL levels, cigarette smoking, documented microalbuminuria). 

Patients who are addicted to nicotine in the form of cigarette smoking have one of the most common, most expensive, and most deadly addictions. Nicotine addiction is the most common cause of preventable death in the United States. Most smokers started in their teen years, and it is very hard for them to quit—possibly the hardest of all of the addictions. Patients with nicotine addiction are at a much increased risk of a long list of cancers, heart disease, and stroke, but they will definitely develop chronic lung disease if they do not die of one of the other risk factors first. 

Although cerebral blood flow is strongly related to hematocrit, any effect of increasing hematocrit on risk of stroke, or type of stroke, is weak and confounded by cigarette smoking, blood pressure and plasma fibrinogen (Welin et al. 1987). However, raised hematocrit does seem to be associated with an increased case-fatality in ischemic stroke (Allport et al. 2005). 

The first was derived from a cohort of 451 patients consecutively admitted to a hospital in North Carolina, USA, between 1977 and 1983 and predicts survival at one and five years (Howard et al. 1987). Using regression modeling to identify independent risk factors, age over 60 years, carotid territory TIA, cigarette smoking, previous contralateral stroke, ischemic heart disease and diabetes mellitus were found to predict an increased risk of death. On internal validation, patients under 60 years of age with none of the above risk factors had a five-year survival of over 95%, while patients over 60 years of age with all of these risk factors had a five-year survival of less than 25%. 

This isn t a book about cholesterol, although I ll discuss it in one of the chapters. This book deals with another one of the Big Three risk factors for heart attack and stroke blood pressure. The third one, by the way, is cigarette smoking. Those three factors are responsible for the vast majority of heart attacks and strokes, although other factors, especially diabetes, come into play as well. 

Hypercholesterolemia—positive risk factor for extracranial atherosclerosis but link still under study for ischemic stroke Cigarette smoking... 

Each year more than 440,000 deaths, or 20% of the total deaths in the United States, are caused by smoking. Cigarette smoking substantially increases the risk of (1) cardiovascular diseases such as stroke, sudden death, and heart attack, (2) nonmalignant respiratory diseases including emphysema, asthma, chronic bronchitis, and chronic obstructive pulmonary disease, (3) lung cancer, and (4) other cancers (e.g., mouth, pharynx, larynx, esophagus, stomach, pancreas, uterus, cervix, kidney, ureter, and bladder). 

In many respects stroke is a preventable disorder. Prevention is the target of a variety of programs to reduce risk factors for stroke. The aim of primary prevention is to reduce the risk of stroke in asymptomatic people. Hypertension, carotid artery stenosis, atrial fibrillation and certain other cardiac conditions, cigarette smoking, diabetes mellitus, dyslipidemia, sickle... 

Although hormonal contraceptives provide an easy and effective means of birth control, their use has been limited somewhat by potentially serious side effects. In particular, contraceptive medications have been associated with cardiovascular problems such as thrombophlebitis, stroke, and myocardial infarction.153 The incidence of these adverse effects, however, seems to depend to a large extent on whether the user has other risk factors associated with cardiovascular disease (smoking cigarettes, hyperlipidemia, hypertension, and so forth).84,120,162 Likewise, cardiovascular risks may be diminished with the newer forms of hormonal contraceptives, which contain relatively less estrogen than their predecessors. 

Stroke is a very uncommon event in childbearing women, occurring in approximately 11 per 100,000 women over a 1-year period of time. Therefore, even a doubling of this risk with oral contraceptive pills would have minimal effect on attributable risk. The estimated risk of myocardial infarction associated with oral contraceptive pill use in nonsmokers is 3 per million women over 1 year. The estimated risk of venous thromboembolism attributable to oral contraceptive pills is less than 3 per 10,000 women per year. However, the risk may be increased in women who smoke or have other predisposing factors to thrombosis or thromboembolism. In fact, it should be emphasized that the risk of serious cardiovascular side effects is particularly marked in women over 35 years of age who are heavy smokers (e.g., more than 15 cigarettes per day). Additionally, the literature suggests that there may be an increased risk of breast cancer associated with long-term oral contraceptive pill use in women under the age of 35. However, because the incidence of breast cancer is so relatively low in this population, the attributable risk of breast cancer from birth control pill use is small. 

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