Ching-Jen Chen1, W Mark Brown1, Charles J Moomaw1, Carl D Langefeld1, Jennifer Osborne1, Bradford B Worrall1, Daniel Woo1, Sebastian Koch2. 1. From the Departments of Neurosurgery (C.-J.C.), Neurology (B.B.W.), and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Center for Public Health Genomics and Department of Biostatistical Sciences (W.M.B., C.D.L.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati College of Medicine, OH; and Department of Neurology (S.K.), University of Miami Miller School of Medicine, FL. Coinvestigators are listed at Neurology.org. 2. From the Departments of Neurosurgery (C.-J.C.), Neurology (B.B.W.), and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Center for Public Health Genomics and Department of Biostatistical Sciences (W.M.B., C.D.L.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati College of Medicine, OH; and Department of Neurology (S.K.), University of Miami Miller School of Medicine, FL. Coinvestigators are listed at Neurology.org. skoch@med.miami.edu.
Abstract
OBJECTIVE: To analyze the dose-risk relationship for alcohol consumption and intracerebral hemorrhage (ICH) in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study. METHODS: ERICH is a multicenter, prospective, case-control study, designed to recruit 1,000 non-Hispanic white patients, 1,000 non-Hispanic black patients, and 1,000 Hispanic patients with ICH. Cases were matched 1:1 to ICH-free controls by age, sex, race/ethnicity, and geographic area. Comprehensive interviews included questions regarding alcohol consumption. Patterns of alcohol consumption were categorized as none, rare (<1 drink per month), moderate (≥1 drink per month and ≤2 drinks per day), intermediate (>2 drinks per day and <5 drinks per day), and heavy (≥5 drinks per day). ICH risk was calculated using the no-alcohol use category as the reference group. RESULTS: Multivariable analyses demonstrated an ordinal trend for alcohol consumption: rare (odds ratio [OR] 0.57, p < 0.0001), moderate (OR 0.65, p < 0.0001), intermediate (OR 0.82, p = 0.2666), and heavy alcohol consumption (OR 1.77, p = 0.0003). Subgroup analyses demonstrated an association of rare and moderate alcohol consumption with decreased risk of both lobar and nonlobar ICH. Heavy alcohol consumption demonstrated a strong association with increased nonlobar ICH risk (OR 2.04, p = 0.0003). Heavy alcohol consumption was associated with significant increase in nonlobar ICH risk in black (OR 2.34, p = 0.0140) and Hispanic participants (OR 12.32, p < 0.0001). A similar association was not found in white participants. CONCLUSIONS: This study demonstrated potential protective effects of rare and moderate alcohol consumption on ICH risk. Heavy alcohol consumption was associated with increased ICH risk. Race/ethnicity was a significant factor in alcohol-associated ICH risk; heavy alcohol consumption in black and Hispanic participants poses significant nonlobar ICH risk.
OBJECTIVE: To analyze the dose-risk relationship for alcohol consumption and intracerebral hemorrhage (ICH) in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study. METHODS: ERICH is a multicenter, prospective, case-control study, designed to recruit 1,000 non-Hispanic white patients, 1,000 non-Hispanic black patients, and 1,000 Hispanic patients with ICH. Cases were matched 1:1 to ICH-free controls by age, sex, race/ethnicity, and geographic area. Comprehensive interviews included questions regarding alcohol consumption. Patterns of alcohol consumption were categorized as none, rare (<1 drink per month), moderate (≥1 drink per month and ≤2 drinks per day), intermediate (>2 drinks per day and <5 drinks per day), and heavy (≥5 drinks per day). ICH risk was calculated using the no-alcohol use category as the reference group. RESULTS: Multivariable analyses demonstrated an ordinal trend for alcohol consumption: rare (odds ratio [OR] 0.57, p < 0.0001), moderate (OR 0.65, p < 0.0001), intermediate (OR 0.82, p = 0.2666), and heavy alcohol consumption (OR 1.77, p = 0.0003). Subgroup analyses demonstrated an association of rare and moderate alcohol consumption with decreased risk of both lobar and nonlobar ICH. Heavy alcohol consumption demonstrated a strong association with increased nonlobar ICH risk (OR 2.04, p = 0.0003). Heavy alcohol consumption was associated with significant increase in nonlobar ICH risk in black (OR 2.34, p = 0.0140) and Hispanic participants (OR 12.32, p < 0.0001). A similar association was not found in white participants. CONCLUSIONS: This study demonstrated potential protective effects of rare and moderate alcohol consumption on ICH risk. Heavy alcohol consumption was associated with increased ICH risk. Race/ethnicity was a significant factor in alcohol-associated ICH risk; heavy alcohol consumption in black and Hispanic participants poses significant nonlobar ICH risk.
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