By Lisa Rapaport

People who smoke or have recently quit have higher odds of being severely impaired after a stroke than their counterparts who never smoked, a new study suggests.

Smoking has long been linked to an increased risk of cardiovascular disease and serious events like heart attacks and strokes. But the new study sheds light on how smoking in the period before a stroke impacts how easily people will be able to navigate daily life afterward.

Compared to nonsmokers, those who were current smokers at the time of their stroke were 29% more likely to have poor functional outcomes afterward, the study found. And while former smokers overall were at no higher risk for poor outcomes than nonsmokers, that wasn’t true for former smokers who had quit within the past two years; this group was 75% more likely to function poorly after the stroke.

The findings were similar for being functionally dependent on others three months after a stroke, the study team notes in the journal Stroke.

“Smoking could be an important and modifiable factor that hinders post-stroke functional recovery,” said study co-author Tetsuro Ago of Kyushu University in Fukuoka, Japan.

“Patients, particularly those harboring stroke risks, should quit smoking as soon as possible,” Ago said by email.

While most stroke patients can recover functionality to some extent after several months, the degree of recovery can vary among individuals, Ago said. Some people can have lasting deficits in physical or mental functioning that make it harder for them to complete daily tasks like dressing, bathing and walking.

Everyone in the current study had an ischemic stroke, the most common kind, which occurs when a clot blocks an artery carrying blood to the brain.

Patients were 70 years old, on average, and roughly one in four were current smokers. Another 32% were former smokers and 43% had no history of smoking.

Among current smokers, the risk of poor functional outcomes increased with the number of cigarettes they smoked each day. Smokers who went through more than a pack a day were 27% to 48% more likely to have poor functional outcomes three months after a stroke than nonsmokers, and they were also 32% to 53% more likely to depend on others to help them get through daily routines.

One limitation of the study is that researchers relied on stroke patients to accurately recall and report any smoking history or current smoking habits. Researchers also lacked data on any secondhand smoke exposure, which might also influence outcomes.

Still, the results suggest that smoking cessation later in life may help minimize disability and disruption to daily life after a stroke, Ago said.

“Smoking cessation may be effective even in elderly patients who have smoked for a long time,” Ago said. “If smokers cannot quit, they should strictly manage other stroke risks, such as hypertension and diabetes, and should exercise and avoid obesity to minimize damage of small blood vessels in the brain.”

SOURCE: https://bit.ly/2FQjySN Stroke, online January 3, 2020.