Smoking-related changes in cerebral perfusion in a population of elderly men

Smoking and hypertension are known causes of stroke and dementia. This study was designed to test the longitudinal effect of lifestyle factors and hypertension on cerebral blood flow (CBF) in old age.

A study of an unselected population cohort of 703 men, born in 1914, has been in progress since 1968 and the last clinical examination occurred at age 69. CBF was examined in 129 survivors who reached 82 years, using SPECT.

At the age of 69, the study subjects consisted of 36 smokers, 37 nonsmokers and 56 former smokers who had quit. Fourteen years later, there were no differences in CBF among them. The cohort was stratified into 69 hypertensive and 60 normotensive men. CBF in normotensives was lowest in smokers and highest in nonsmokers. No CBF differences were observed in hypertensive men regarding smoking, but their CBF was as low as in normotensive smokers. Hypertensives had a higher BMI, and higher blood glucose and triglyceride levels, but lower alcohol consumption at 69 and a lower ankle-brachial pressure index at 82 years. Alcohol consumption was highest in normotensive smokers.

Smoking and high alcohol consumption in normotensive men are correlated to low CBF in senescence. Low CBF in hypertensive men regardless of smoking may be due to a high vascular risk profile.