(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
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