Is the stroke risk from smoking genetically determined?

Smoking and stroke: a mendelian randomization study.

Larsson SC, Burgess S, Michaëlsson K

Ann Neurol 2019; 86:468-471.



We used the Mendelian randomization design to explore the potential causal association of smoking with ischemic stroke and intracerebral hemorrhage using summary statistics data for 34,217 ischemic stroke cases and 404,630 noncases, and 1,545 cases of intracerebral hemorrhage and 1,481 noncases.


Genetic predisposition to smoking initiation (ever smoking regularly), based on up to 372 single-nucleotide polymorphisms, was statistically significantly positively associated with any ischemic stroke, large artery stroke, and small vessel stroke but not cardioembolic stroke or intracerebral hemorrhage.


This study provides genetic support for a causal association of smoking with ischemic stroke, particularly large artery and small vessel stroke.

This paper is cited in the neurochecklist:

Ischaemic stroke: non-genetic risk factors

Abstract link

By Kruscha – archive copy at the Wayback Machine (archived on 19 January 2019), CC0, Link

By Ibrahim Imam

I am a UK Neurologist keen on general neurology, but with an interest in neuromuscular diseases. I maintain the neurology searchable database, I also blog at I share and discuss current issues around clinical neurology. I hope you find my blogs enlightening, practical, and even entertaining.

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