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Alcohol consumption and stroke incidence in male smokers.

Abstract

BACKGROUND

Studies on alcohol consumption and incidences of stroke subtypes have suggested distinct dose-response relationships. Blood pressure and HDL cholesterol mediate the effect of alcohol on coronary heart disease, but similar evidence on cerebrovascular diseases is not available.

METHODS AND RESULTS

We studied the risk of stroke in 26 556 male cigarette smokers 50 to 69 years of age without history of stroke. The men were categorized as nondrinkers, light (</=24 g/d), moderate (25 to 60 g/d), or heavy (>60 g/d) drinkers. A total of 960 men suffered from incident stroke: 83 with subarachnoid and 95 with intracerebral hemorrhage, 733 with cerebral infarction, and 49 with unspecified stroke. The adjusted relative risk of subarachnoid hemorrhage was 1.0 in light drinkers, 1.3 in moderate drinkers, and 1.6 in heavy drinkers compared with nondrinkers. The respective relative risks of intracerebral hemorrhage were 0.8, 0.6, and 1.8; of cerebral infarction, 0.9, 1.2, and 1.5. Systolic blood pressure attenuated the effect of alcohol consumption in all subtypes of stroke, whereas HDL cholesterol strengthened the effect of alcohol in subarachnoid hemorrhage and cerebral infarction but attenuated the effect in intracerebral hemorrhage.

CONCLUSIONS

Alcohol consumption may have a distinct dose-response relationship within each stroke subtype-linear in subarachnoid hemorrhage, U-shaped in intracerebral hemorrhage, and J-shaped in cerebral infarction-but further studies are warranted. Systolic blood pressure and HDL cholesterol seem to mediate the effect of alcohol on stroke incidence, but evidently additional mechanisms are involved.

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  • Authors+Show Affiliations

    ,

    Department of Public Health, University of Helsinki, Finland. jaana.leppala@helsinki.fi

    , , , , ,

    Source

    Circulation 100:11 1999 Sep 14 pg 1209-14

    MeSH

    Aged
    Alcohol Drinking
    Blood Pressure
    Cerebral Hemorrhage
    Cerebral Infarction
    Cerebrovascular Disorders
    Cholesterol, HDL
    Dose-Response Relationship, Drug
    Humans
    Male
    Middle Aged
    Risk Factors
    Smoking
    Subarachnoid Hemorrhage

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    10484542

    Citation

    Leppälä, J M., et al. "Alcohol Consumption and Stroke Incidence in Male Smokers." Circulation, vol. 100, no. 11, 1999, pp. 1209-14.
    Leppälä JM, Paunio M, Virtamo J, et al. Alcohol consumption and stroke incidence in male smokers. Circulation. 1999;100(11):1209-14.
    Leppälä, J. M., Paunio, M., Virtamo, J., Fogelholm, R., Albanes, D., Taylor, P. R., & Heinonen, O. P. (1999). Alcohol consumption and stroke incidence in male smokers. Circulation, 100(11), pp. 1209-14.
    Leppälä JM, et al. Alcohol Consumption and Stroke Incidence in Male Smokers. Circulation. 1999 Sep 14;100(11):1209-14. PubMed PMID: 10484542.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Alcohol consumption and stroke incidence in male smokers. AU - Leppälä,J M, AU - Paunio,M, AU - Virtamo,J, AU - Fogelholm,R, AU - Albanes,D, AU - Taylor,P R, AU - Heinonen,O P, PY - 1999/9/14/pubmed PY - 1999/9/14/medline PY - 1999/9/14/entrez SP - 1209 EP - 14 JF - Circulation JO - Circulation VL - 100 IS - 11 N2 - BACKGROUND: Studies on alcohol consumption and incidences of stroke subtypes have suggested distinct dose-response relationships. Blood pressure and HDL cholesterol mediate the effect of alcohol on coronary heart disease, but similar evidence on cerebrovascular diseases is not available. METHODS AND RESULTS: We studied the risk of stroke in 26 556 male cigarette smokers 50 to 69 years of age without history of stroke. The men were categorized as nondrinkers, light (</=24 g/d), moderate (25 to 60 g/d), or heavy (>60 g/d) drinkers. A total of 960 men suffered from incident stroke: 83 with subarachnoid and 95 with intracerebral hemorrhage, 733 with cerebral infarction, and 49 with unspecified stroke. The adjusted relative risk of subarachnoid hemorrhage was 1.0 in light drinkers, 1.3 in moderate drinkers, and 1.6 in heavy drinkers compared with nondrinkers. The respective relative risks of intracerebral hemorrhage were 0.8, 0.6, and 1.8; of cerebral infarction, 0.9, 1.2, and 1.5. Systolic blood pressure attenuated the effect of alcohol consumption in all subtypes of stroke, whereas HDL cholesterol strengthened the effect of alcohol in subarachnoid hemorrhage and cerebral infarction but attenuated the effect in intracerebral hemorrhage. CONCLUSIONS: Alcohol consumption may have a distinct dose-response relationship within each stroke subtype-linear in subarachnoid hemorrhage, U-shaped in intracerebral hemorrhage, and J-shaped in cerebral infarction-but further studies are warranted. Systolic blood pressure and HDL cholesterol seem to mediate the effect of alcohol on stroke incidence, but evidently additional mechanisms are involved. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/10484542/Alcohol_consumption_and_stroke_incidence_in_male_smokers_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=10484542.ui DB - PRIME DP - Unbound Medicine ER -