Smoking is associated with silent cerebrovascular disease in a high-risk Japanese community-dwelling population

We aimed to investigate the relationships between smoking and silent cerebrovascular damage. We performed brain MRI to evaluate silent cerebral infarct (SCI) and periventricular hyperintensity (PVH), and carotid-ultrasonography to investigate carotid atherosclerotic plaque in 170 high-risk community-dwelling subjects (mean age: 67.2 years; men: 28.7%) who met more than 3 of the following 9 criteria: 1) high blood pressure (BP); 2) hypercholesterolemia; 3) left ventricular hypertrophy; 4) high hemoglobin A(1C); 5) proteinuria; 6) high waist-to-hip ratio; 7) smoking greater than or equal to 30 cigarettes/day; 8) heavy alcohol intake; 9) family history of stroke. The subjects with SCI (SCI group) were older (70 years vs. 66 years, p = 0.004) and had higher systolic BP (SBP) (160 vs. 148mmHg, p < 0.001) and higher carotid plaque score (2.3 vs. 1.5/person, p < 0.05) than those without SCI Among the variables, smoking status (r = 0.34, p < 0.001), SBP (r = 0.28, p < 0.001), male gender (r = 0.29, p < 0.001), left ventricular mass index (r = 0.25, p = 0.001), and serum creatinine (r = 0.20, p = 0.006) were significantly correlated with the number of SCIs. Among smokers, the number of SCIs was significantly higher in current smokers than in past smokers (1.9 +/- 2.2 vs. 0.5 +/- 0.8, p < 0.01). In multiple regression analysis, smoking status (beta = 0.183, p = 0.045) and SBP (beta = 0.196, p = 0.011) were independent determinants of the increased number of SCIs. In conclusion, smoking status was an independent determinant of multiple SCIs in a high-risk Japanese community-dwelling population.