on March 11, 2004
Published online before print March 11, 2004, doi: 10.1161/01.STR.0000124459.33597.00
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Submitted on August 21, 2003
From Department of Public Health Medicine (H.I.), Institute of Community Medicine, University of Tsukuba, Tennodai, Tuskuba-shi, Ibaraki-ken, Japan; Department of Preventive Medicine (S.B., T.M.), National Cardiovascular Center, Osaka, Japan; Department of Internal Medicine (S.B.), Hanwa Daini Senpoku Hospital, Osaka, Japan; National Institute of Health and Nutrition (S.S.), Tokyo, Japan; Department of Public Health (K.O., M.K.), University of Ehime, Ehime, Japan; Epidemiology and Prevention Division (S.T.), Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan. * To whom correspondence should be addressed. E-mail: stsugane{at}ncc.go.jp.
Background 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 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,
Revised on January 7, 2004
Accepted on January 9, 2004
Alcohol Consumption and Risk of Stroke Among Middle-Aged Men: The JPHC Study Cohort I
Hiroyasu Iso MD;
450 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).
2 drinks per day, does not raise the risk of total stroke.
Key words: alcohol • stroke • risk factors
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