Abstract P385: Cigarette Smoking and Incident Stroke in African Americans of the Jackson Heart Study

Abstract

Background: African-Americans (AAs) are disproportionately affected more by stroke compared to whites, however less is known about the relationship between stroke and cigarette smoking, a modifiable risk factor, in AAs. Therefore, we evaluated the relationship between cigarette smoking and incident stroke in the Jackson Heart Study (JHS). Methods and Results: JHS participants without a history of stroke (n= 4894) were classified by self-reported baseline smoking status into current, past (smoked at least 400 cigarettes/life) or never smokers at baseline (2000-2004). Current smokers were further classified by smoking intensity [number of cigarettes smoked per day (1-10,10-19 and ≥20)] and followed for incident stroke (through 2014). Stroke events were adjudicated in the JHS. Hazard ratios for incident stroke for each smoking group compared to never smokers were estimated using the Cox proportional hazard regression models after adjusting for covariates. At baseline there were 633 (13.1%) current, 892 (18.4%) past and 3327 (68.6%) never smokers. During follow-up (11.8 median follow-up years), 201 participants developed incident stroke. After adjusting for age, sex, body mass index, hypertension, diabetes mellitus status, total cholesterol, triglycerides, prevalent cardiovascular disease, physical activity, aspirin, statin, and alcohol consumption in the past 12 months and level of education, the risk for stroke in current smokers was significantly higher compared to never smokers (HR 2.33, 95% CI 1.16-4.68) but there was no significant difference between past smokers and never smokers (HR 0.96, 95% CI 0.53-1.75).There was a dose-dependent increased risk of stroke with smoking intensity which was not statistically significant. Conclusions: In a large prospective cohort of AAs, current cigarette smoking was associated with incident stroke in adjusted models. These findings suggest that smoking cessation may have potential benefits in reducing the incidence of stroke in this population.