Which of the following is a risk factor for vertebrobasilar insufficiency?

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Vertebrobasilar insufficiency stems from reduced blood flow in the posterior circulation, most often due to atherosclerotic disease in the vertebral or basilar arteries. Smoking contributes to this risk by accelerating atherosclerosis, damaging the endothelium, increasing platelet aggregation, and causing vasoconstriction. These effects narrow the arteries supplying the brainstem and cerebellum, making ischemia more likely, especially with other vascular risks.

Regular exercise tends to protect vascular health, lowering blood pressure and improving lipid profiles, so it’s not a risk factor for this condition. Vitamin C deficiency isn’t a recognized driver of vertebrobasilar insufficiency; it causes vascular fragility in scurvy but doesn’t specifically promote posterior circulation ischemia. A high calcium diet isn’t a standard risk factor for vertebrobasilar insufficiency in typical risk-factor models, though calcium metabolism has other health implications.