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Alcohol use and risk of ischemic stroke among older adults: the cardiovascular health study.
Stroke 2005; 36(9):1830-4S

Abstract

BACKGROUND AND PURPOSE

The association of light to moderate alcohol consumption with risk of ischemic stroke remains uncertain, as are the roles of potentially mediating factors and modification by apolipoprotein E (apoE) genotype.

METHODS

We studied the prospective association of alcohol consumption and risk of ischemic stroke among 4410 participants free of cardiovascular disease at baseline in the Cardiovascular Health Study, a population-based cohort study of older adults from 4 US communities. Participants reported their consumption of alcoholic beverages yearly.

RESULTS

During an average follow-up period of 9.2 years, 434 cases of incident ischemic stroke occurred. Compared with long-term abstainers, the multivariate relative risks of ischemic stroke were 0.85 (95% CI, 0.63 to 1.13), 0.75 (95% CI, 0.53 to 1.06), 0.82 (95% CI, 0.51 to 1.30), and 1.03 (95% CI, 0.68 to 1.57) among consumers of <1, 1 to 6, 7 to 13, and > or =14 drinks per week (P quadratic trend 0.06). ApoE genotype appeared to modify the alcohol-ischemic stroke relationship (P interaction 0.08), with generally lower risks among drinkers than abstainers in apoE4-negative participants but higher risks among drinkers than abstainers among apoE4-positive participants. We could not identify candidate mediators among lipid, inflammatory, and prothrombotic factors.

CONCLUSIONS

In this study of older adults, the association of alcohol use and risk of ischemic stroke was U-shaped, with modestly lower risk among consumers of 1 to 6 drinks per week. However, apoE genotype may modify this association, and even moderate alcohol intake may be associated with an increased risk of ischemic stroke among apoE4-positive older adults.

Authors+Show Affiliations

Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA. kmukamal@bidmc.harvard.edu

Pub Type(s)

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

Language

eng

PubMed ID

16081863

Citation

Mukamal, Kenneth J., et al. "Alcohol Use and Risk of Ischemic Stroke Among Older Adults: the Cardiovascular Health Study." Stroke, vol. 36, no. 9, 2005, pp. 1830-4.
Mukamal KJ, Chung H, Jenny NS, et al. Alcohol use and risk of ischemic stroke among older adults: the cardiovascular health study. Stroke. 2005;36(9):1830-4.
Mukamal, K. J., Chung, H., Jenny, N. S., Kuller, L. H., Longstreth, W. T., Mittleman, M. A., ... Siscovick, D. S. (2005). Alcohol use and risk of ischemic stroke among older adults: the cardiovascular health study. Stroke, 36(9), pp. 1830-4.
Mukamal KJ, et al. Alcohol Use and Risk of Ischemic Stroke Among Older Adults: the Cardiovascular Health Study. Stroke. 2005;36(9):1830-4. PubMed PMID: 16081863.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alcohol use and risk of ischemic stroke among older adults: the cardiovascular health study. AU - Mukamal,Kenneth J, AU - Chung,Hyoju, AU - Jenny,Nancy S, AU - Kuller,Lewis H, AU - Longstreth,W T,Jr AU - Mittleman,Murray A, AU - Burke,Gregory L, AU - Cushman,Mary, AU - Beauchamp,Norman J,Jr AU - Siscovick,David S, Y1 - 2005/08/04/ PY - 2005/8/6/pubmed PY - 2006/1/13/medline PY - 2005/8/6/entrez SP - 1830 EP - 4 JF - Stroke JO - Stroke VL - 36 IS - 9 N2 - BACKGROUND AND PURPOSE: The association of light to moderate alcohol consumption with risk of ischemic stroke remains uncertain, as are the roles of potentially mediating factors and modification by apolipoprotein E (apoE) genotype. METHODS: We studied the prospective association of alcohol consumption and risk of ischemic stroke among 4410 participants free of cardiovascular disease at baseline in the Cardiovascular Health Study, a population-based cohort study of older adults from 4 US communities. Participants reported their consumption of alcoholic beverages yearly. RESULTS: During an average follow-up period of 9.2 years, 434 cases of incident ischemic stroke occurred. Compared with long-term abstainers, the multivariate relative risks of ischemic stroke were 0.85 (95% CI, 0.63 to 1.13), 0.75 (95% CI, 0.53 to 1.06), 0.82 (95% CI, 0.51 to 1.30), and 1.03 (95% CI, 0.68 to 1.57) among consumers of <1, 1 to 6, 7 to 13, and > or =14 drinks per week (P quadratic trend 0.06). ApoE genotype appeared to modify the alcohol-ischemic stroke relationship (P interaction 0.08), with generally lower risks among drinkers than abstainers in apoE4-negative participants but higher risks among drinkers than abstainers among apoE4-positive participants. We could not identify candidate mediators among lipid, inflammatory, and prothrombotic factors. CONCLUSIONS: In this study of older adults, the association of alcohol use and risk of ischemic stroke was U-shaped, with modestly lower risk among consumers of 1 to 6 drinks per week. However, apoE genotype may modify this association, and even moderate alcohol intake may be associated with an increased risk of ischemic stroke among apoE4-positive older adults. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/16081863/Alcohol_use_and_risk_of_ischemic_stroke_among_older_adults:_the_cardiovascular_health_study_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.STR.0000177587.76846.89?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -