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Alcohol consumption and risk of stroke: a meta-analysis.
JAMA 2003; 289(5):579-88JAMA

Abstract

CONTEXT

Observational studies suggest that heavy alcohol consumption may increase the risk of stroke while moderate consumption may decrease the risk.

OBJECTIVE

To examine the association between alcohol consumption and relative risk of stroke.

DATA SOURCES

Studies published in English-language journals were retrieved by searching MEDLINE (1966-April 2002) using Medical Subject Headings alcohol drinking, ethanol, cerebrovascular accident, cerebrovascular disorders, and intracranial embolism and thrombosis and the key word stroke; Dissertation Abstracts Online using the keywords stroke and alcohol; and bibliographies of retrieved articles.

STUDY SELECTION

From 122 relevant retrieved reports, 35 observational studies (cohort or case control) in which total stroke, ischemic stroke, or hemorrhagic (intracerebral or total) stroke was an end point; the relative risk or relative odds and their variance (or data to calculate them) of stroke associated with alcohol consumption were reported; alcohol consumption was quantified; and abstainers served as the reference group.

DATA EXTRACTION

Information on study design, participant characteristics, level of alcohol consumption, stroke outcome, control for potential confounding factors, and risk estimates was abstracted independently by 3 investigators using a standardized protocol.

DATA SYNTHESIS

A random-effects model and meta-regression analysis were used to pool data from individual studies. Compared with abstainers, consumption of more than 60 g of alcohol per day was associated with an increased relative risk of total stroke, 1.64 (95% confidence interval [CI], 1.39-1.93); ischemic stroke, 1.69 (95% CI, 1.34-2.15); and hemorrhagic stroke, 2.18 (95% CI, 1.48-3.20), while consumption of less than 12 g/d was associated with a reduced relative risk of total stroke, 0.83 (95%, CI, 0.75-0.91) and ischemic stroke, 0.80 (95% CI, 0.67-0.96), and consumption of 12 to 24 g/d was associated with a reduced relative risk of ischemic stroke, 0.72 (95%, CI, 0.57-0.91). The meta-regression analysis revealed a significant nonlinear relationship between alcohol consumption and total and ischemic stroke and a linear relationship between alcohol consumption and hemorrhagic stroke.

CONCLUSIONS

These results indicate that heavy alcohol consumption increases the relative risk of stroke while light or moderate alcohol consumption may be protective against total and ischemic stroke.

Authors+Show Affiliations

Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, Tulane University Health Sciences Center, 1430 Tulane Ave SL18, New Orleans, LA 70112, USA. kreynol1@tulane.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

12578491

Citation

Reynolds, Kristi, et al. "Alcohol Consumption and Risk of Stroke: a Meta-analysis." JAMA, vol. 289, no. 5, 2003, pp. 579-88.
Reynolds K, Lewis B, Nolen JD, et al. Alcohol consumption and risk of stroke: a meta-analysis. JAMA. 2003;289(5):579-88.
Reynolds, K., Lewis, B., Nolen, J. D., Kinney, G. L., Sathya, B., He, J., & Lewis, B. L. (2003). Alcohol consumption and risk of stroke: a meta-analysis. JAMA, 289(5), pp. 579-88.
Reynolds K, et al. Alcohol Consumption and Risk of Stroke: a Meta-analysis. JAMA. 2003 Feb 5;289(5):579-88. PubMed PMID: 12578491.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alcohol consumption and risk of stroke: a meta-analysis. AU - Reynolds,Kristi, AU - Lewis,Brian, AU - Nolen,John David L, AU - Kinney,Gregory L, AU - Sathya,Bhavani, AU - He,Jiang, AU - Lewis,Brian L, PY - 2003/2/13/pubmed PY - 2003/2/21/medline PY - 2003/2/13/entrez SP - 579 EP - 88 JF - JAMA JO - JAMA VL - 289 IS - 5 N2 - CONTEXT: Observational studies suggest that heavy alcohol consumption may increase the risk of stroke while moderate consumption may decrease the risk. OBJECTIVE: To examine the association between alcohol consumption and relative risk of stroke. DATA SOURCES: Studies published in English-language journals were retrieved by searching MEDLINE (1966-April 2002) using Medical Subject Headings alcohol drinking, ethanol, cerebrovascular accident, cerebrovascular disorders, and intracranial embolism and thrombosis and the key word stroke; Dissertation Abstracts Online using the keywords stroke and alcohol; and bibliographies of retrieved articles. STUDY SELECTION: From 122 relevant retrieved reports, 35 observational studies (cohort or case control) in which total stroke, ischemic stroke, or hemorrhagic (intracerebral or total) stroke was an end point; the relative risk or relative odds and their variance (or data to calculate them) of stroke associated with alcohol consumption were reported; alcohol consumption was quantified; and abstainers served as the reference group. DATA EXTRACTION: Information on study design, participant characteristics, level of alcohol consumption, stroke outcome, control for potential confounding factors, and risk estimates was abstracted independently by 3 investigators using a standardized protocol. DATA SYNTHESIS: A random-effects model and meta-regression analysis were used to pool data from individual studies. Compared with abstainers, consumption of more than 60 g of alcohol per day was associated with an increased relative risk of total stroke, 1.64 (95% confidence interval [CI], 1.39-1.93); ischemic stroke, 1.69 (95% CI, 1.34-2.15); and hemorrhagic stroke, 2.18 (95% CI, 1.48-3.20), while consumption of less than 12 g/d was associated with a reduced relative risk of total stroke, 0.83 (95%, CI, 0.75-0.91) and ischemic stroke, 0.80 (95% CI, 0.67-0.96), and consumption of 12 to 24 g/d was associated with a reduced relative risk of ischemic stroke, 0.72 (95%, CI, 0.57-0.91). The meta-regression analysis revealed a significant nonlinear relationship between alcohol consumption and total and ischemic stroke and a linear relationship between alcohol consumption and hemorrhagic stroke. CONCLUSIONS: These results indicate that heavy alcohol consumption increases the relative risk of stroke while light or moderate alcohol consumption may be protective against total and ischemic stroke. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/12578491/Alcohol_consumption_and_risk_of_stroke:_a_meta_analysis_ L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.289.5.579 DB - PRIME DP - Unbound Medicine ER -