Sara B Jones1, Laura Loehr2, Christy L Avery2, Rebecca F Gottesman2, Lisa Wruck2, Eyal Shahar2, Wayne D Rosamond2. 1. From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.). sara.jones@unc.edu. 2. From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.).
Abstract
BACKGROUND AND PURPOSE: Alcohol consumption is common in the United States and may confer beneficial cardiovascular effects at light-to-moderate doses. The alcohol-stroke relationship remains debated. We estimated the relationship between midlife, self-reported alcohol consumption and ischemic stroke and intracerebral hemorrhage (ICH) in a biracial cohort. METHODS: We examined 12,433 never and current drinkers in the Atherosclerosis Risk in Communities study, aged 45 to 64 years at baseline. Participants self-reported usual drinks per week of beer, wine, and liquor at baseline. We used multivariate Cox proportional hazards regression to assess the association of current alcohol consumption relative to lifetime abstention with incident ischemic stroke and ICH and modification by sex-race group. We modeled alcohol intake with quadratic splines to further assess dose-response relationships. RESULTS: One third of participants self-reported abstention, 39% and 24%, respectively, consumed ≤3 and 4 to 17 drinks/wk, and only 5% reported heavier drinking. There were 773 ischemic strokes and 81 ICH over follow-up (median≈22.6 years). For ischemic stroke, light and moderate alcohol consumption were not associated with incidence (hazard ratios, 0.98; 95% CI, 0.79-1.21; 1.06, 0.84-1.34), whereas heavier drinking was associated with a 31% increased rate relative to abstention (hazard ratios, 1.31; 95% CI, 0.92-1.86). For ICH, moderate-to-heavy (hazard ratios, 1.99; 95% CI, 1.07-3.70), but not light, consumption increased incidence. CONCLUSIONS: Self-reported light-to-moderate alcohol consumption at midlife was not associated with reduced stroke risk compared with abstention over 20 years of follow-up in the Atherosclerosis Risk in Communities study. Heavier consumption increased the risk for both outcomes as did moderate intake for ICH.
BACKGROUND AND PURPOSE:Alcohol consumption is common in the United States and may confer beneficial cardiovascular effects at light-to-moderate doses. The alcohol-stroke relationship remains debated. We estimated the relationship between midlife, self-reported alcohol consumption and ischemic stroke and intracerebral hemorrhage (ICH) in a biracial cohort. METHODS: We examined 12,433 never and current drinkers in the Atherosclerosis Risk in Communities study, aged 45 to 64 years at baseline. Participants self-reported usual drinks per week of beer, wine, and liquor at baseline. We used multivariate Cox proportional hazards regression to assess the association of current alcohol consumption relative to lifetime abstention with incident ischemic stroke and ICH and modification by sex-race group. We modeled alcohol intake with quadratic splines to further assess dose-response relationships. RESULTS: One third of participants self-reported abstention, 39% and 24%, respectively, consumed ≤3 and 4 to 17 drinks/wk, and only 5% reported heavier drinking. There were 773 ischemic strokes and 81 ICH over follow-up (median≈22.6 years). For ischemic stroke, light and moderate alcohol consumption were not associated with incidence (hazard ratios, 0.98; 95% CI, 0.79-1.21; 1.06, 0.84-1.34), whereas heavier drinking was associated with a 31% increased rate relative to abstention (hazard ratios, 1.31; 95% CI, 0.92-1.86). For ICH, moderate-to-heavy (hazard ratios, 1.99; 95% CI, 1.07-3.70), but not light, consumption increased incidence. CONCLUSIONS: Self-reported light-to-moderate alcohol consumption at midlife was not associated with reduced stroke risk compared with abstention over 20 years of follow-up in the Atherosclerosis Risk in Communities study. Heavier consumption increased the risk for both outcomes as did moderate intake for ICH.
Authors: Monik Jimenez; Stephanie E Chiuve; Robert J Glynn; Meir J Stampfer; Carlos A Camargo; Walter C Willett; Joann E Manson; Kathryn M Rexrode Journal: Stroke Date: 2012-03-08 Impact factor: 7.914
Authors: Alan S Go; Dariush Mozaffarian; Véronique L Roger; Emelia J Benjamin; Jarett D Berry; William B Borden; Dawn M Bravata; Shifan Dai; Earl S Ford; Caroline S Fox; Sheila Franco; Heather J Fullerton; Cathleen Gillespie; Susan M Hailpern; John A Heit; Virginia J Howard; Mark D Huffman; Brett M Kissela; Steven J Kittner; Daniel T Lackland; Judith H Lichtman; Lynda D Lisabeth; David Magid; Gregory M Marcus; Ariane Marelli; David B Matchar; Darren K McGuire; Emile R Mohler; Claudia S Moy; Michael E Mussolino; Graham Nichol; Nina P Paynter; Pamela J Schreiner; Paul D Sorlie; Joel Stein; Tanya N Turan; Salim S Virani; Nathan D Wong; Daniel Woo; Melanie B Turner Journal: Circulation Date: 2012-12-12 Impact factor: 29.690
Authors: Jayadeep Patra; Benjamin Taylor; Hyacinth Irving; Michael Roerecke; Dolly Baliunas; Satya Mohapatra; Jürgen Rehm Journal: BMC Public Health Date: 2010-05-18 Impact factor: 3.295
Authors: Mitchell S V Elkind; Robert Sciacca; Bernadette Boden-Albala; Tanja Rundek; Myunghee C Paik; Ralph L Sacco Journal: Stroke Date: 2005-11-23 Impact factor: 7.914
Authors: Solveig A Cunningham; Aleena Mosher; Suzanne E Judd; Lisa M Matz; Edmond K Kabagambe; Claudia S Moy; Virginia J Howard Journal: J Gerontol B Psychol Sci Soc Sci Date: 2018-04-16 Impact factor: 4.077
Authors: Kira S Birditt; Angela Turkelson; Courtney A Polenick; James A Cranford; Frederic C Blow Journal: J Gerontol B Psychol Sci Soc Sci Date: 2022-09-01 Impact factor: 4.942
Authors: Barbara Riegel; Debra K Moser; Harleah G Buck; Victoria Vaughan Dickson; Sandra B Dunbar; Christopher S Lee; Terry A Lennie; JoAnn Lindenfeld; Judith E Mitchell; Diane J Treat-Jacobson; David E Webber Journal: J Am Heart Assoc Date: 2017-08-31 Impact factor: 5.501