Men who smoke have better outcomes after a stroke

The following study, whose abstract is below, finds that men who smoke have better outcomes after atherosclerotic stroke than men who have never smoked, research suggests.

Bang OY, Park HY, Lee PH, Kim GM, Chung CS, Lee KH. Improved outcome after atherosclerotic stroke in male smoker.J Neurol Sci. 2007;260: 43-8.

Department of Neurology, Sungkyunkwan University School of Medicine, Seoul, South Korea.

BACKGROUND: Smoking is a well-known risk factor for ischaemic stroke or transient ischaemic attack. Paradoxically, smokers have been reported to have better prognosis after myocardial infarction when compared to nonsmokers. This study examined the independent effect of smoking status on long-term prognosis after ischaemic stroke in male patients.

METHODS: A total 476 male patients with acute cerebral infarction within the middle cerebral artery territory were reviewed. Baseline characteristics and long-term prognosis were compared among smokers, ex-smokers, and nonsmokers.

RESULTS: Although the baseline severity of stroke did not differ among the groups, poor long-term outcome (Barthel index<60 or modified Rankin score>3) at 6 months after ischaemic stroke was more frequently observed in nonsmokers than in smokers (P=0.013); the outcome for ex-smokers was intermediate. After adjustment for age and other variables, current smoking was negatively correlated to poor long-term outcome (odds ratio, 0.286; 95% confidence interval, 0.119-0.686; P=0.005). On subgroup analysis, the impact of smoking on stroke prognosis was significant only in younger patients (less than 65 years of age) and those with atherosclerotic stroke.

CONCLUSIONS: There was a strong independent correlation between smoking status and long-term outcome in patients with ischaemic stroke. Further studies about the impact of smoking habit on stroke outcome depending on the characteristics of patients (ie. age and stroke subtype) are needed.

COMMENT: So smokers have less than one third of the complications of strokes, compared with non-smokers. And it's not just men who have had an ischaemic stroke that benefit from being smokers; it's the same story with heart attacks — smokers survive them better as well.

It has to be said, however, that smokers tend to have more ischaemic strokes and heart attacks than non-smokers, so it might balance out.

Interestingly, smoking has also been shown to lower the risk of some neurologic disorders, including Alzheimer's and Parkinson's diseases.