Published online before print March 11, 2004, doi: 10.1161/01.STR.0000124459.33597.00
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2004;35:1124.)
© 2004 American Heart Association, Inc.
Original Contributions |
Alcohol Consumption and Risk of Stroke Among Middle-Aged Men: The JPHC Study Cohort I
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.
Correspondence to Dr Hiroyasu Iso, Department of Public Health Medicine, Institute of Community Medicine, University of Tsukuba, 1-1-1 Tennodai, Tuskuba-shi, Ibaraki-ken 305-3985 Japan. E-mail fvgh5640{at}mb.infoweb.ne.jp Reprint requests to Dr Shoichiro Tsugane, Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 Japan. Email stsugane@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 
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).
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, 
2 drinks per day, does not raise the risk of total stroke.
Key Words: alcohol • stroke • risk factors
This article has been cited by other articles:
 |
|
 |
|
  I. Laonigro, M. Correale, M. Di Biase, and E. Altomare Alcohol abuse and heart failure Eur J Heart Fail, May 1, 2009; 11(5): 453 - 462. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. M. Snow, R. Murray, O. Ekuma, S. L. Tyas, and G. E. Barnes Alcohol use and cardiovascular health outcomes: a comparison across age and gender in the Winnipeg Health and Drinking Survey Cohort Age Ageing, March 1, 2009; 38(2): 206 - 212. [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]
|
|
|
|
 |
|
 J. S. Berger, C. B. Frye, Q. Harshaw, F. H. Edwards, S. R. Steinhubl, and R. C. Becker Impact of Clopidogrel in Patients With Acute Coronary Syndromes Requiring Coronary Artery Bypass Surgery: A Multicenter Analysis J. Am. Coll. Cardiol., November 18, 2008; 52(21): 1693 - 1701. [Abstract] [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]
|
|
|
|
 |
|
 S. Ito, R. Takachi, M. Inoue, N. Kurahashi, M. Iwasaki, S. Sasazuki, H. Iso, Y. Tsubono, S. Tsugane, and for the JPHC Study Group Education in relation to incidence of and mortality from cancer and cardiovascular disease in Japan Eur J Public Health, October 1, 2008; 18(5): 466 - 472. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Takachi, M. Inoue, J. Ishihara, N. Kurahashi, M. Iwasaki, S. Sasazuki, H. Iso, Y. Tsubono, S. Tsugane, and for the JPHC Study Group Fruit and Vegetable Intake and Risk of Total Cancer and Cardiovascular Disease: Japan Public Health Center-based Prospective Study Am. J. Epidemiol., January 1, 2008; 167(1): 59 - 70. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Kokubo, H. Iso, J. Ishihara, K. Okada, M. Inoue, S. Tsugane, and for the JPHC Study Group Association of Dietary Intake of Soy, Beans, and Isoflavones With Risk of Cerebral and Myocardial Infarctions in Japanese Populations: The Japan Public Health Center Based (JPHC) Study Cohort I Circulation, November 27, 2007; 116(22): 2553 - 2562. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Broderick, S. Connolly, E. Feldmann, D. Hanley, C. Kase, D. Krieger, M. Mayberg, L. Morgenstern, C. S. Ogilvy, P. Vespa, et al. REPRINT: Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults: 2007 Update: A Guideline From the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Circulation, October 16, 2007; 116(16): e391 - e413. [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]
|
|
|
|
|
|
J. Broderick, S. Connolly, E. Feldmann, D. Hanley, C. Kase, D. Krieger, M. Mayberg, L. Morgenstern, C. S. Ogilvy, P. Vespa, et al. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults: 2007 Update: A Guideline From the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke, June 1, 2007; 38(6): 2001 - 2023. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Husain, M. Vazquez-Ortiz, and J. Lalla Down regulation of aortic nitric oxide and antioxidant systems in chronic alcohol-induced hypertension in rats Human and Experimental Toxicology, May 1, 2007; 26(5): 427 - 434. [Abstract] [PDF]
|
|
|
|
|
|
T. Marugame, S. Yamamoto, I. Yoshimi, T. Sobue, M. Inoue, S. Tsugane, and for the Japan Public Health Center-based Prospecti Patterns of Alcohol Drinking and All-Cause Mortality: Results from a Large-Scale Population-based Cohort Study in Japan Am. J. Epidemiol., May 1, 2007; 165(9): 1039 - 1046. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. B. Goldstein, R. Adams, M. J. Alberts, L. J. Appel, L. M. Brass, C. D. Bushnell, A. Culebras, T. J. DeGraba, P. B. Gorelick, J. R. Guyton, et al. Primary Prevention of Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline. Circulation, June 20, 2006; 113(24): e873 - e923. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. B. Goldstein, R. Adams, M. J. Alberts, L. J. Appel, L. M. Brass, C. D. Bushnell, A. Culebras, T. J. DeGraba, P. B. Gorelick, J. R. Guyton, et al. Primary Prevention of Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline. Stroke, June 1, 2006; 37(6): 1583 - 1633. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Tsivgoulis, K. Spengos, and N. Zakopoulos Diurnal Blood Pressure Changes in Stroke Subtypes Hypertension, June 1, 2006; 47(6): e26 - e26. [Full Text] [PDF]
|
|
|
|
|
|
R. L. Sacco, R. Adams, G. Albers, M. J. Alberts, O. Benavente, K. Furie, L. B. Goldstein, P. Gorelick, J. Halperin, R. Harbaugh, et al. Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline. Circulation, March 14, 2006; 113(10): e409 - e449. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Sacco, R. Adams, G. Albers, M. J. Alberts, O. Benavente, K. Furie, L. B. Goldstein, P. Gorelick, J. Halperin, R. Harbaugh, et al. Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline. Stroke, February 1, 2006; 37(2): 577 - 617. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. CECCANTI, G. F. SASSO, R. NOCENTE, G. BALDUCCI, A. PRASTARO, C. TICCHI, G. BERTAZZONI, P. SANTINI, and M. L. ATTILIA HYPERTENSION IN EARLY ALCOHOL WITHDRAWAL IN CHRONIC ALCOHOLICS Alcohol Alcohol., January 1, 2006; 41(1): 5 - 10. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S.V. Elkind, R. Sciacca, B. Boden-Albala, T. Rundek, M. C. Paik, and R. L. Sacco Moderate Alcohol Consumption Reduces Risk of Ischemic Stroke: The Northern Manhattan Study Stroke, January 1, 2006; 37(1): 13 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. L. Klatsky Editorial Comment--Alcohol and Stroke: An Epidemiological Labyrinth Stroke, September 1, 2005; 36(9): 1835 - 1836. [Full Text] [PDF]
|
|
|
|
|
|
H. C. Kim, D. R. Kang, C. M. Nam, N. W. Hur, J. S. Shim, S. H. Jee, and I. Suh Elevated Serum Aminotransferase Level as a Predictor of Intracerebral Hemorrhage: Korea Medical Insurance Corporation Study Stroke, August 1, 2005; 36(8): 1642 - 1647. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Hanley and W. Hacke Critical Care and Emergency Medicine Neurology in Stroke Stroke, February 1, 2005; 36(2): 205 - 207. [Full Text] [PDF]
|
|