Advances in Stroke

Introduction

Individual cohort studies may lack the sample size necessary for precise subgroup estimates of vascular risk. Whether women and men are at similar cigarette smoking-related stroke risk was uncertain. A meta-analysis of 81 cohorts, including almost 4 million persons, found both women (relative risk [RR], 1.83; 95% confidence interval [CI], 1.58–2.1) and men (RR, 1.67; 95% CI, 1.49–1.88) who are current cigarette smokers are at increased stroke risk with the risk similar regardless of sex (RR ratio for women versus men, 1.06; 95% CI, 0.99–1.13).¹ Another study confirmed the association between physical inactivity and stroke risk (hazard ratio [HR], 1.20; 95% CI, 1.02–1.42), an effect that was partially attenuated by traditional stroke risk factors (diabetes mellitus, hypertension, body mass index, alcohol use, and smoking; HR, 1.14; 95% CI, 0.95–1.37), suggesting that exercise might partially reduce the effect of other risk factors or reflect a healthy-user effect.²

Up to one third of strokes are cryptogenic. A randomized trial found that 7 days of noninvasive cardiac-event monitoring, in addition to a standard evaluation, beginning within 7 days of stroke detected atrial fibrillation in 44% of patients compared with 4% having a standard evaluation alone (P<0.001).³ Prolonged cardiac monitoring may …