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Differing association of alcohol consumption with different stroke types: a systematic review and meta-analysis.
BMC Med 2016; 14(1):178BM

Abstract

BACKGROUND

Whether light-to-moderate alcohol consumption is protective against stroke, and whether any association differs by stroke type, is controversial. We conducted a meta-analysis to summarize the evidence from prospective studies on alcohol drinking and stroke types.

METHODS

Studies were identified by searching PubMed to September 1, 2016, and reference lists of retrieved articles. Additional data from 73,587 Swedish adults in two prospective studies were included. Study-specific results were combined in a random-effects model.

RESULTS

The meta-analysis included 27 prospective studies with data on ischemic stroke (25 studies), intracerebral hemorrhage (11 studies), and/or subarachnoid hemorrhage (11 studies). Light and moderate alcohol consumption was associated with a lower risk of ischemic stroke, whereas high and heavy drinking was associated with an increased risk; the overall RRs were 0.90 (95 % CI, 0.85-0.95) for less than 1 drink/day, 0.92 (95 % CI, 0.87-0.97) for 1-2 drinks/day, 1.08 (95 % CI, 1.01-1.15) for more than 2-4 drinks/day, and 1.14 (95 % CI, 1.02-1.28) for more than 4 drinks/day. Light and moderate alcohol drinking was not associated with any hemorrhagic stroke subtype. High alcohol consumption (>2-4 drinks/day) was associated with a non-significant increased risk of both hemorrhagic stroke subtypes, and the relative risk for heavy drinking (>4 drinks/day) were 1.67 (95 % CI, 1.25-2.23) for intracerebral hemorrhage and 1.82 (95 % CI, 1.18-2.82) for subarachnoid hemorrhage.

CONCLUSION

Light and moderate alcohol consumption was inversely associated only with ischemic stroke, whereas heavy drinking was associated with increased risk of all stroke types with a stronger association for hemorrhagic strokes.

Authors+Show Affiliations

Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden. susanna.larsson@ki.se. Stroke Research Group, Neurology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK. susanna.larsson@ki.se.Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden.Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden.Stroke Research Group, Neurology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27881167

Citation

Larsson, Susanna C., et al. "Differing Association of Alcohol Consumption With Different Stroke Types: a Systematic Review and Meta-analysis." BMC Medicine, vol. 14, no. 1, 2016, p. 178.
Larsson SC, Wallin A, Wolk A, et al. Differing association of alcohol consumption with different stroke types: a systematic review and meta-analysis. BMC Med. 2016;14(1):178.
Larsson, S. C., Wallin, A., Wolk, A., & Markus, H. S. (2016). Differing association of alcohol consumption with different stroke types: a systematic review and meta-analysis. BMC Medicine, 14(1), p. 178.
Larsson SC, et al. Differing Association of Alcohol Consumption With Different Stroke Types: a Systematic Review and Meta-analysis. BMC Med. 2016 11 24;14(1):178. PubMed PMID: 27881167.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differing association of alcohol consumption with different stroke types: a systematic review and meta-analysis. AU - Larsson,Susanna C, AU - Wallin,Alice, AU - Wolk,Alicja, AU - Markus,Hugh S, Y1 - 2016/11/24/ PY - 2016/07/12/received PY - 2016/10/17/accepted PY - 2016/11/25/entrez PY - 2016/11/25/pubmed PY - 2017/7/14/medline KW - Alcohol consumption KW - Meta-analysis KW - Prospective studies KW - Stroke SP - 178 EP - 178 JF - BMC medicine JO - BMC Med VL - 14 IS - 1 N2 - BACKGROUND: Whether light-to-moderate alcohol consumption is protective against stroke, and whether any association differs by stroke type, is controversial. We conducted a meta-analysis to summarize the evidence from prospective studies on alcohol drinking and stroke types. METHODS: Studies were identified by searching PubMed to September 1, 2016, and reference lists of retrieved articles. Additional data from 73,587 Swedish adults in two prospective studies were included. Study-specific results were combined in a random-effects model. RESULTS: The meta-analysis included 27 prospective studies with data on ischemic stroke (25 studies), intracerebral hemorrhage (11 studies), and/or subarachnoid hemorrhage (11 studies). Light and moderate alcohol consumption was associated with a lower risk of ischemic stroke, whereas high and heavy drinking was associated with an increased risk; the overall RRs were 0.90 (95 % CI, 0.85-0.95) for less than 1 drink/day, 0.92 (95 % CI, 0.87-0.97) for 1-2 drinks/day, 1.08 (95 % CI, 1.01-1.15) for more than 2-4 drinks/day, and 1.14 (95 % CI, 1.02-1.28) for more than 4 drinks/day. Light and moderate alcohol drinking was not associated with any hemorrhagic stroke subtype. High alcohol consumption (>2-4 drinks/day) was associated with a non-significant increased risk of both hemorrhagic stroke subtypes, and the relative risk for heavy drinking (>4 drinks/day) were 1.67 (95 % CI, 1.25-2.23) for intracerebral hemorrhage and 1.82 (95 % CI, 1.18-2.82) for subarachnoid hemorrhage. CONCLUSION: Light and moderate alcohol consumption was inversely associated only with ischemic stroke, whereas heavy drinking was associated with increased risk of all stroke types with a stronger association for hemorrhagic strokes. SN - 1741-7015 UR - https://www.unboundmedicine.com/medline/citation/27881167/full_citation L2 - https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0721-4 DB - PRIME DP - Unbound Medicine ER -