Adults smokers with limited education face a greater risk of stroke than those with a higher education, according to new research in the American Heart Association’s journal Stroke.

The combination of smoking and high blood pressure increased stroke risk the most, confirming earlier findings in numerous studies.

In a multicenter Danish study, researchers defined lower education as grade school or lower secondary school (maximum of 10 years) education.

“We found it is worse being a current smoker with lower education than a current smoker with a higher education,” said Helene Nordahl, Ph.D., M.S.C., study lead author and researcher at the Department of Public Health at the University of Copenhagen in Denmark. “Targeted interventions aimed at reducing smoking and high blood pressure in lower socioeconomic groups would yield a greater reduction in stroke than targeting the same behaviors in higher socioeconomic groups.”