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Smoking and white matter hyperintensity progression: the ARIC-MRI Study.

TitleSmoking and white matter hyperintensity progression: the ARIC-MRI Study.
Publication TypeJournal Article
Year of Publication2015
AuthorsPower MC, Deal JA, Sharrett ARichey, Jack CR, Knopman D, Mosley TH
Secondary AuthorsGottesman RF
Date Published2015 Feb 24
KeywordsAfrican Continental Ancestry Group, Aged, Cohort Studies, Disease Progression, European Continental Ancestry Group, Female, Humans, Intracranial Arteriosclerosis, Magnetic Resonance Imaging, Male, Middle Aged, Population Surveillance, Prospective Studies, Risk Factors, Smoking, White Matter

OBJECTIVE: Our objective was to examine the link between smoking and smoking history, including smoking intensity and cessation, overall and by race, in a biracial prospective cohort study.

METHODS: A subset of Atherosclerosis Risk in Communities Study participants (n = 972, 49% black) completed brain MRI scans twice (1993-1995 and 2004-2006). We defined white matter hyperintensity (WMH) progression as an increase of ≥2 points on the 9-point Cardiovascular Health Study scale across scans. Participants reported information on smoking behavior at the baseline MRI and at 2 prior study visits, approximately 3 and 6 years before baseline. We used adjusted logistic regression to evaluate the association between smoking variables and WMH progression in the total sample and separately by race (black and white).

RESULTS: We found WMH progression in 23% of participants (30% of black participants, 17% of white participants). Overall, being a current smoker 6 years before baseline was associated with WMH progression. In race-stratified analyses, we found adverse associations with smoking status at multiple time points and persistent smoking in white but not in black participants. However, we found no statistical support for effect modification by race for most of these analyses. Increasing pack-years of smoking was associated with greater risk of WMH progression, while time since quitting and age at smoking initiation were not associated with WMH progression, with little indication of differences in these associations by race.

CONCLUSIONS: Our findings concur with previous studies suggesting a relationship between smoking and WMH progression, and further demonstrate a dose-dependent association.

Alternate JournalNeurology
PubMed ID25632094
PubMed Central IDPMC4345648
Grant ListU01 HL096812 / HL / NHLBI NIH HHS / United States
T32 AG027668 / AG / NIA NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
R01-HL70825 / HL / NHLBI NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States