Alcohol Consumption and Risk of Stroke Among Middle-Aged Men: The JPHC Study Cohort I

Abstract

MD; for the JPHC Study GroupBackground and Purpose-The impact of light-to-moderate alcohol consumption on risk of stroke has not been well examined in a single study, although the effect is hypothesized to differ among stroke subtypes from meta-analyses. Methods-A total of 19 544 men aged 40 to 59 years living in communities were followed-up from 1990 to 1992 to the end of 2001 in the Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Disease (JPHC Study). Results-After 214 504 person-years of follow-up, 694 incident strokes were documented, of which 611 were confirmed by imaging studies or autopsy, including 219 intraparenchymal hemorrhages, 73 subarachnoid hemorrhages, and 319 ischemic strokes. Alcohol consumption was positively associated with age-adjusted risk of total stroke with a 68% excess risk among drinkers of Ն450 g ethanol per week compared with occasional drinkers. This excess risk was confined primarily to hemorrhagic stroke, which remained statistically significant even after controlling for hypertension and other cardiovascular risk factors (RR: 2.15; 95% CI: 1.22 to 3.79). There was a lower risk of ischemic stroke, more specifically lacunar infarction, a higher risk of hemorrhagic stroke, and no excess risk of total stroke among drinkers of 1 to 149 g ethanol per week compared with occasional drinkers; the respective multivariate RR (95% CI) was 0.59 (0.37 to 0.93), 0.43 (0.22 to 0.87), 1.73 (0.98 to 3.07), and 0.98 (0.71 to 1.36). Conclusions-We found differential effects of light-to-moderate alcohol consumption on risks of hemorrhagic and ischemic strokes among middle-aged men. Light-to-moderate alcohol consumption, ie, Յ2 drinks per day, does not raise the risk of total stroke.

Physio-pathological effects of alcohol on the cardiovascular system: its role in hypertension and cardiovascular disease

“…A positive linear relationship has been observed between the level of alcohol consumption and risk of brain or subarachnoid hemorrhage. 8,110,116,117 Actions on the BP and blood coagulation system seem to be underlying mechanisms for this adverse influence of alcohol.…”

“…110,[116][117][118] The low risk in light drinkers seems to be due to the lower degree of atherosclerosis and the inhibition of blood coagulation, as in the case of ischemic heart disease. The increased risk in heavy drinkers is probably related to increases in the level and variability of the BP, hemoconcentration because of dehydration and thromboembolism associated with alcohol-induced atrial fibrillation.…”

Lifestyle and Cardiovascular Disease in Japan

“…An 11-year follow-up of the JPHC Study of 19,544 men aged 40 to 59 years 27) showed that alcohol consumption was associated with an elevated risk of total stroke for drinkers with an alcohol intake of 450 g ethanol per week compared with occasional drinkers. This excess risk was confined primarily to hemorrhagic stroke with a multivariable HR of 2.15 (95% CI: 1.22-3.79).…”

Hepatoprotective Effects of a Concentrate and Components of Sake against Galactosamine (GalN)-Induced Liver Injury in Mice

“…[6][7][8][9] The U-shaped relationship between alcohol intake and ischemic stroke and the alcohol-dependent increase in hemorrhagic stroke were also observed in Japan. 10) Favorable associations between light-to-moderate alcohol intake and health issues have been suggested, but most of the studies were conducted without attention to the type of alcoholic beverages consumed. Several epidemiological studies have described the association of the type of alcoholic beverage with health problems, but no differences were observed in the type of alcoholic beverage consumed.…”