(Stroke. 1995;26:767-773.)
© 1995 American Heart Association, Inc.
Articles |
Alcohol Intake and the Risk of Cardiovascular Disease in Middle-Aged Japanese Men
From the Institute of Community Medicine, University of Tsukuba, Tsukuba (H.I., T. Shimamoto, T. Sankai); the Department of Epidemiology and Mass Examination, The Center for Adult Diseases, Osaka (A.K., Y.N., S.S., M.K., M.I.); and the Osaka Prefectural Institute of Public Health, Osaka (Y.K.); Japan.
Background and Purpose Understanding the effects of alcohol intake on stroke and other cardiovascular diseases is an important issue for public health.
Methods A 10.5-year prospective study of the relationship between alcohol intake and cardiovascular disease incidence was conducted in 2890 men, aged 40 to 69 years and free of a history of stroke and coronary heart disease, in three rural communities of Japan.
Results One hundred seventy-eight strokes (40 intracerebral
hemorrhages, 18 subarachnoid hemorrhages, 104 nonhemorrhagic strokes,
and 16 unclassified strokes), 34 coronary heart disease events, and 19
sudden unclassified deaths occurred. Drinkers of 
70 g/d ethanol had
an approximately 2.5 times higher age-adjusted risk of all stroke than
never-drinkers; the excess risk was more evident for hemorrhagic stroke
than nonhemorrhagic stroke. When hypertension category, serum total
cholesterol level, cigarette smoking, and diabetes mellitus were taken
into account, these excess risks were reduced but remained significant
for all stroke (2.0; 95% confidence interval, 1.3 to 3.1) and
hemorrhagic stroke (3.4; 95% confidence interval, 1.2 to 9.2). A
J-shaped relationship was suggested between
alcohol intake and risk of nonhemorrhagic stroke; drinkers of <42 g/d
ethanol had a slightly lower risk and heavy drinkers had a higher risk
than never-drinkers. Current drinkers had a slightly lower risk of
coronary heart disease than never-drinkers, although the risk
difference was not statistically significant. The age-adjusted risk of
sudden death was 10 times higher in heavy drinkers than never-drinkers,
and the excess risk did not change when the covariates were controlled
for. Total cardiovascular disease showed a similar pattern as did all
stroke.
Conclusions Heavy drinking appeared to increase the risk of hemorrhagic stroke, in part due to hypertension, and to increase the risk of sudden death, which was probably due to drinking per se. Light or moderate alcohol consumption seemed to protect against nonhemorrhagic stroke and coronary heart disease.
Key Words: alcohol drinking • coronary heart disease • Japan • risk factors
This article has been cited by other articles:
 |
|
 |
|
  I Saito, M Konishi, H Iso, M Inoue, and S Tsugane Impact of weight change on specific-cause mortality among middle-aged Japanese individuals J Epidemiol Community Health, June 1, 2009; 63(6): 447 - 454. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Ohira, T. Tanigawa, M. Tabata, H. Imano, A. Kitamura, M. Kiyama, S. Sato, T. Okamura, R. Cui, K. A. Koike, et al. Effects of Habitual Alcohol Intake on Ambulatory Blood Pressure, Heart Rate, and Its Variability Among Japanese Men Hypertension, January 1, 2009; 53(1): 13 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Iso Changes in Coronary Heart Disease Risk Among Japanese Circulation, December 16, 2008; 118(25): 2725 - 2729. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Ikehara, H. Iso, H. Toyoshima, C. Date, A. Yamamoto, S. Kikuchi, T. Kondo, Y. Watanabe, A. Koizumi, Y. Wada, et al. Alcohol Consumption and Mortality From Stroke and Coronary Heart Disease Among Japanese Men and Women: The Japan Collaborative Cohort Study Stroke, November 1, 2008; 39(11): 2936 - 2942. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Kloner and S. H. Rezkalla To Drink or Not to Drink? That Is the Question Circulation, September 11, 2007; 116(11): 1306 - 1317. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Iso, S. Baba, T. Mannami, S. Sasaki, K. Okada, M. Konishi, S. Tsugane, and for the JPHC Study Group Alcohol Consumption and Risk of Stroke Among Middle-Aged Men: The JPHC Study Cohort I Stroke, May 1, 2004; 35(5): 1124 - 1129. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Reynolds, L. B. Lewis, J. D. L. Nolen, G. L. Kinney, B. Sathya, and J. He Alcohol Consumption and Risk of Stroke: A Meta-analysis JAMA, February 5, 2003; 289(5): 579 - 588. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Masters and J. S. Stevenson A Theoretical Model of the Role of Brain Stem Nuclei in Alcohol-Mediated Arrhythmogenesis in Older Adults Biol Res Nurs, January 1, 2003; 4(3): 218 - 231. [Abstract] [PDF]
|
|
|
|
 |
|
 Y. Chen, G. Davis-Gorman, R. R. Watson, and P. F. McDonagh CHRONIC ETHANOL CONSUMPTION MODULATES MYOCARDIAL ISCHAEMIA-REPERFUSION INJURY IN MURINE AIDS Alcohol Alcohol., January 1, 2003; 38(1): 18 - 24. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Iso, S. Sato, A. Kitamura, Y. Naito, T. Shimamoto, and Y. Komachi Fat and Protein Intakes and Risk of Intraparenchymal Hemorrhage among Middle-aged Japanese Am. J. Epidemiol., January 1, 2003; 157(1): 32 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Chen, G. Davis-Gorman, R. R. Watson, and P. F. McDonagh ETHANOL MODULATES CORONARY PERMEABILITY TO MACROMOLECULES IN MURINE AIDS Alcohol Alcohol., November 1, 2002; 37(6): 555 - 560. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Saloheimo, S. Juvela, and M. Hillbom Use of Aspirin, Epistaxis, and Untreated Hypertension as Risk Factors for Primary Intracerebral Hemorrhage in Middle-Aged and Elderly People Stroke, February 1, 2001; 32(2): 399 - 404. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Sjogren, A. Eriksson, G. Brostrom, and K. Ahlm QUANTIFICATION OF ALCOHOL-RELATED MORTALITY IN SWEDEN Alcohol Alcohol., November 1, 2000; 35(6): 601 - 611. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. J. Tegos, E. Kalodiki, S.-S. Daskalopoulou, and A. N. Nicolaides Stroke: Epidemiology, Clinical Picture, and Risk Factors: Part I of III Angiology, October 1, 2000; 51(10): 793 - 808. [Abstract] [PDF]
|
|
|
|
 |
|
 J.A. Papadakis, E.S. Ganotakis, and D.P. Mikhailidis Beneficial effect of moderate alcohol consumption on vascular disease: myth or reality? Perspectives in Public Health, March 1, 2000; 120(1): 11 - 15. [Abstract] [PDF]
|
|
|
|
 |
|
 M. Hommel and A. Jaillard Alcohol for Stroke Prevention? N. Engl. J. Med., November 18, 1999; 341(21): 1605 - 1606. [Full Text]
|
|
|
|
|
|
M. Hillbom, H. Numminen, and S. Juvela Recent Heavy Drinking of Alcohol and Embolic Stroke Stroke, November 1, 1999; 30 (11): 2307 - 2312. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. L Hart, G. D. Smith, D. J Hole, and V. M Hawthorne Alcohol consumption and mortality from all causes, coronary heart disease, and stroke: results from a prospective cohort study of Scottish men with 21 years of follow up BMJ, June 26, 1999; 318(7200): 1725 - 1729. [Abstract] [Full Text]
|
|
|
|
 |
|
 M. Kahonen, K. Karjala, N. Hutri-Kahonen, X. Wu, P. Jaatinen, P. Riihioja, A. Hervonen, and I. Porsti Influence of chronic ethanol consumption on arterial tone in young and aged rats Am J Physiol Heart Circ Physiol, February 1, 1999; 276(2): H464 - H471. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Iso, T. Shimamoto, Y. Naito, S. Sato, A. Kitamura, M. Iida, M. Konishi, D. R. Jacobs Jr, and Y. Komachi Effects of a Long-term Hypertension Control Program on Stroke Incidence and Prevalence in a Rural Community in Northeastern Japan Stroke, August 1, 1998; 29(8): 1510 - 1518. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kobayashi, K. Okada, H. Koide, H. Bokura, and S. Yamaguchi Subcortical Silent Brain Infarction as a Risk Factor for Clinical Stroke Stroke, October 1, 1997; 28(10): 1932 - 1939. [Abstract] [Full Text]
|
|
|
|
|
|
H. Haapaniemi, M. Hillbom, and S. Juvela Lifestyle-Associated Risk Factors for Acute Brain Infarction Among Persons of Working Age Stroke, January 1, 1997; 28(1): 26 - 30. [Abstract] [Full Text]
|
|
|
|
|
|
T. Nakayama, C. Date, T. Yokoyama, N. Yoshiike, M. Yamaguchi, and H. Tanaka A 15.5-Year Follow-up Study of Stroke in a Japanese Provincial City: The Shibata Study Stroke, January 1, 1997; 28(1): 45 - 52. [Abstract] [Full Text]
|
|
|
|
|
|
Council on Scientific Affairs, American Medical As, Y. D. Coble Jr, R. M. Davis, C. A. Head, J. P. Howe III, M. S. Karlan, W. R. Kennedy, P. J. Numann, M. A. Spillman, W. D. Skelton, et al. Alcoholism in the Elderly JAMA, March 13, 1996; 275(10): 797 - 801. [Abstract] [PDF]
|
|