Alcohol intake and risk of stroke: A dose–response meta-analysis of prospective studies

Zhang, Chi; Qin, Yingyi; Chen, Qi; Jiang, Hong; Chen, Xianzhen; Xu, Chunli; Mao, Pei-Juan; He, Jia; Zhou, Yuhao

doi:10.1016/j.ijcard.2014.04.225

Cited by 150 publications

(136 citation statements)

References 49 publications

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“…A study has demonstrated a J-shaped association between alcohol intake and stroke morbidity and mortality [29]. A higher initial mRS could correlate with a greater degree of medical complications, which explains its association with a higher mortality.…”

Section: Discussionmentioning

confidence: 99%

Mortality and Stroke Recurrence in a Rehabilitation Cohort of Patients with Cerebral Infarcts and Chagas Disease

et al. 2018

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Background: Chagas disease is related to ischemic stroke (IS), although few epidemiological studies have evaluated the associated mortality and recurrence. Our objective is to determine factors associated with mortality and recurrence of IS in patients with IS and Chagas disease. Methods: We retrospectively studied data obtained from electronic medical records of patients admitted at SARAH Hospitals across Brazil between 2009 and 2013. Using Cox regression analysis for mortality and logistic regression for recurrence, we assessed primary population characteristics and statistical associations between risk factors and outcomes. Results: We analyzed 279 patients who were followed up until 2016. The mean age at stroke onset was 61 with a 10% frequency of death. Multivariate analysis assessing mortality demonstrated that the associated factors were age at stroke (hazard ratio [HR] 1.04), initial modified Rankin Scale (mRS; HR 20.91), bladder dysfunction (HR 2.51), diabetes mellitus (DM; HR 3.64), and alcoholism (HR 3.37). Multivariate analysis assessing recurrence demonstrated that the associated factors were age at ictus (OR 0.96), cognitive deficit (OR 0.44), initial mRS (OR 1.84), cardioembolic etiology (OR 2.47), and female sex (OR 2.73). Conclusions: Cardiac conditions did not correlate with mortality or recurrence. Age was a protective factor against recurrence, probably due to cumulative risk of IS over time, while initial mRS was associated with both outcomes. Treating diseases such as DM and bladder dysfunction, and early treatment to reduce the initial mRS could potentially prevent both outcomes; also, establishing a correct etiological diagnosis is important.

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Section: Discussionmentioning

confidence: 99%

Mortality and Stroke Recurrence in a Rehabilitation Cohort of Patients with Cerebral Infarcts and Chagas Disease

et al. 2018

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“…Recent reviewers have concluded that there is probably a J-curve relationship between alcohol consumption and the risk of stroke [75,83]. At present, the relations between alcohol drinking and specific stroke types remain unclear.…”

Section: Cerebrovascular Diseasementioning

confidence: 99%

Alcohol and cardiovascular diseases: where do we stand today?

2015

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Abstract. Klatsky AL (Northern California Kaiser Permanente, Oakland, CA, USA). Alcohol and cardiovascular diseases: where do we stand today?. (Review). J Intern Med 2015;278: 238-250.For centuries, multiple medical risks of heavy alcohol drinking have been evident with simultaneous awareness of a less harmful or sensible drinking limit. The increased risks of heavy drinking, defined as three or more standard-sized drinks per day, are both cardiovascular (CV) and non-CV. The CV risks include the following: (i) alcoholic cardiomyopathy (ACM), (ii) systemic hypertension, (iii) atrial arrhythmias, (iv) haemorrhagic stroke and, probably, ischaemic stroke. By contrast, modern epidemiological studies have shown lower morbidity and mortality amongst light-moderate drinkers, due mostly to a reduced risk of coronary artery disease (CAD), with contributions from ischaemic stroke and heart failure (HF). A low level of alcohol drinking has no clear relation to increased risk of any CV condition, except for haemorrhagic stroke. There is good evidence that supports the existence of mechanisms by which alcohol might protect against CAD, but the mechanisms for other alcohol-CV associations remain unclear. Interrelationships amongst the CV conditions affect the individual alcohol-disease relationships; for example, lower CAD risk in lightmoderate drinkers is to a large extent responsible for the reduced HF risk. International comparison data plus the presence of proposed beneficial nonalcohol components in wine (particularly in red wine) suggest that this beverage type might afford extra CAD protection. However, the effect of beverage choice is confounded by a healthier drinking pattern and more favourable risk traits in wine drinkers. Debate persists about methodological and public health issues related to the epidemiology of alcohol-related CV disease.

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“…Examining alcohol consumption and diet has been controversial when creating recommendations for disease prevention. Although a number of studies have shown that low or moderate alcohol consumption is associated with decreased risk of cardiovascular disease, the evidence for alcohol and stroke is mixed 24 . A 2014 meta-analysis of 15 studies observed a non-linear, J-shaped association between alcohol intake and stroke risk 24 .…”

Section: Mediterranean Diet and Stroke Preventionmentioning

confidence: 99%