Poorly Educated Adult Smokers at a Higher Risk of Stroke

Researchers have found that poorly educated adults face an elevated risk of stroke than those with higher education.

Several pieces of research, conducted earlier, have highlighted that smoking is a major risk factor for cardiovascular diseases including stroke and heart attacks. When compared to non-smokers, smokers are at a three-fold increased risk of stroke.

The latest Danish study confirms the association between the two factors.

The multicenter study reveals that adult smokers with limited education face a greater risk of stroke, the fourth leading cause of death in America and the leading cause of adult disability. Lower education has been defined as grade school or lower secondary school education (maximum of 10 years).

"We found it is worse being a current smoker with lower education than a current smoker with a higher education," said Helene Nordahl, Ph.D., M.S.C., study lead author and researcher at the Department of Public Health at the University of Copenhagen in Denmark. "Targeted interventions aimed at reducing smoking and high blood pressure in lower socioeconomic groups would yield a greater reduction in stroke than targeting the same behaviors in higher socioeconomic groups."

The finding was based on the evaluation of 68,643 adults who were further divided into groups of low, medium and high education levels. Their smoking and high blood pressure was assessed.

The researchers noticed that 16 percent of the men and 11 percent of women were at a higher risk of suffering a stroke due to limited education level, smoking and high blood pressure. When compared to women, men faced a higher risk of stroke and the risk increased with age. 

Nearly 10 percent of high-risk men and 9 percent of high-risk women had an ischemic stroke during the 14-year follow-up period. The high risk of stroke was among smokers with low education than smokers with higher education, irrespective of their blood pressure levels.

"Universal interventions such as legislation or taxation could also have a strong effect on stroke in the most disadvantaged," Nordahl said. "We need to challenge disparities in unhealthy behaviors, particularly smoking."

The investigators found it challenging to pick differences linked with ethnicity because 98 percent of the subjects were Danes.

"The distribution of stroke risk factors may vary across various contexts and study populations," Nordahl said. "However, since the most disadvantaged groups are often exposed to a wide number of stroke risk factors, it seems plausible that these people are at higher risk of stroke not only in Denmark, but also in other industrialized countries."

The finding was documented in the American Heart Association journal Stroke.