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Alcohol intake and risk of stroke: a dose-response meta-analysis of prospective studies.

Abstract

BACKGROUND

Alcohol intake is inconsistently associated with the risk of stroke morbidity and mortality. The purpose of this study was to summarize the evidence regarding this relationship by using a dose-response meta-analytic approach.

METHODS

We performed electronic searches of PubMed, EMBASE, and the Cochrane Library to identify relevant prospective studies. Only prospective studies that reported effect estimates with 95% confidence intervals (CIs) of stroke morbidity and mortality for more than 2 categories of alcohol intake were included.

RESULTS

We included 27 prospective studies reporting data on 1,425,513 individuals. Low alcohol intake was associated with a reduced risk of total stroke (risk ratio [RR], 0.85; 95% CI: 0.75-0.95; P=0.005), ischemic stroke (RR, 0.81; 95% CI: 0.74-0.90; P<0.001), and stroke mortality (RR, 0.67; 95% CI: 0.53-0.85; P=0.001), but it had no significant effect on hemorrhagic stroke. Moderate alcohol intake had little or no effect on the risks of total stroke, hemorrhagic stroke, ischemic stroke, and stroke mortality. Heavy alcohol intake was associated with an increased risk of total stroke (RR, 1.20; 95% CI: 1.01-1.43; P=0.034), but it had no significant effect on hemorrhagic stroke, ischemic stroke, and stroke mortality.

CONCLUSIONS

Low alcohol intake is associated with a reduced risk of stroke morbidity and mortality, whereas heavy alcohol intake is associated with an increased risk of total stroke. The association between alcohol intake and stroke morbidity and mortality is J-shaped.

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  • Authors+Show Affiliations

    ,

    Department of Neurosurgery, Shanghai Seventh People's Hospital, Shanghai 200137, China.

    ,

    Department of Health Statistics, Second Military Medical University, Shanghai 200433, China.

    ,

    Department of Health Statistics, Second Military Medical University, Shanghai 200433, China.

    ,

    Department of Politics, Second Military Medical University, Shanghai 200433, China.

    ,

    Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.

    ,

    Department of Neurology, Shanghai Seventh People's Hospital, Shanghai 200137, China.

    ,

    Department of VIP Special Clinic, Shanghai Seventh People's Hospital, Shanghai 200137, China.

    ,

    Department of Health Statistics, Second Military Medical University, Shanghai 200433, China. Electronic address: hejia63@yeah.net.

    Department of Rehabilitation Institute, Shanghai Seventh People's Hospital, Shanghai 200137, China. Electronic address: zhou_ly@126.com.

    Source

    International journal of cardiology 174:3 2014 Jul 01 pg 669-77

    MeSH

    Alcohol Drinking
    Alcoholic Beverages
    Cohort Studies
    Dose-Response Relationship, Drug
    Ethanol
    Humans
    Prospective Studies
    Risk Factors
    Stroke

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    24820756

    Citation

    Zhang, Chi, et al. "Alcohol Intake and Risk of Stroke: a Dose-response Meta-analysis of Prospective Studies." International Journal of Cardiology, vol. 174, no. 3, 2014, pp. 669-77.
    Zhang C, Qin YY, Chen Q, et al. Alcohol intake and risk of stroke: a dose-response meta-analysis of prospective studies. Int J Cardiol. 2014;174(3):669-77.
    Zhang, C., Qin, Y. Y., Chen, Q., Jiang, H., Chen, X. Z., Xu, C. L., ... Zhou, Y. H. (2014). Alcohol intake and risk of stroke: a dose-response meta-analysis of prospective studies. International Journal of Cardiology, 174(3), pp. 669-77. doi:10.1016/j.ijcard.2014.04.225.
    Zhang C, et al. Alcohol Intake and Risk of Stroke: a Dose-response Meta-analysis of Prospective Studies. Int J Cardiol. 2014 Jul 1;174(3):669-77. PubMed PMID: 24820756.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Alcohol intake and risk of stroke: a dose-response meta-analysis of prospective studies. AU - Zhang,Chi, AU - Qin,Ying-Yi, AU - Chen,Qi, AU - Jiang,Hong, AU - Chen,Xian-Zhen, AU - Xu,Chun-Li, AU - Mao,Pei-Juan, AU - He,Jia, AU - Zhou,Yu-Hao, Y1 - 2014/04/26/ PY - 2013/10/01/received PY - 2014/04/15/revised PY - 2014/04/18/accepted PY - 2014/5/14/entrez PY - 2014/5/14/pubmed PY - 2015/2/13/medline KW - Alcohol intake KW - Dose–response KW - Meta-analysis KW - Stroke SP - 669 EP - 77 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 174 IS - 3 N2 - BACKGROUND: Alcohol intake is inconsistently associated with the risk of stroke morbidity and mortality. The purpose of this study was to summarize the evidence regarding this relationship by using a dose-response meta-analytic approach. METHODS: We performed electronic searches of PubMed, EMBASE, and the Cochrane Library to identify relevant prospective studies. Only prospective studies that reported effect estimates with 95% confidence intervals (CIs) of stroke morbidity and mortality for more than 2 categories of alcohol intake were included. RESULTS: We included 27 prospective studies reporting data on 1,425,513 individuals. Low alcohol intake was associated with a reduced risk of total stroke (risk ratio [RR], 0.85; 95% CI: 0.75-0.95; P=0.005), ischemic stroke (RR, 0.81; 95% CI: 0.74-0.90; P<0.001), and stroke mortality (RR, 0.67; 95% CI: 0.53-0.85; P=0.001), but it had no significant effect on hemorrhagic stroke. Moderate alcohol intake had little or no effect on the risks of total stroke, hemorrhagic stroke, ischemic stroke, and stroke mortality. Heavy alcohol intake was associated with an increased risk of total stroke (RR, 1.20; 95% CI: 1.01-1.43; P=0.034), but it had no significant effect on hemorrhagic stroke, ischemic stroke, and stroke mortality. CONCLUSIONS: Low alcohol intake is associated with a reduced risk of stroke morbidity and mortality, whereas heavy alcohol intake is associated with an increased risk of total stroke. The association between alcohol intake and stroke morbidity and mortality is J-shaped. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/24820756/Alcohol_intake_and_risk_of_stroke:_a_dose_response_meta_analysis_of_prospective_studies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(14)00907-3 DB - PRIME DP - Unbound Medicine ER -