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(Stroke. 2008;39:2936.)
© 2008 American Heart Association, Inc.

Original Contributions

Alcohol Consumption and Mortality From Stroke and Coronary Heart Disease Among Japanese Men and Women

The Japan Collaborative Cohort Study

Satoyo Ikehara, MSc; Hiroyasu Iso, MD; Hideaki Toyoshima, MD; Chigusa Date, PhD; Akio Yamamoto; Shogo Kikuchi, MD; Takaaki Kondo, MD; Yoshiyuki Watanabe, MD; Akio Koizumi, MD; Yasuhiko Wada, MD; Yutaka Inaba, MD; Akiko Tamakoshi, MD Japan Collaborative Cohort Study Group

From Public Health, Department of Social and Environmental Medicine (S.I., H.I.), Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Public Health/Health Information Dynamics (H.T., T.K.), Fields of Science, Program of Health and Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Food Science and Nutrition (C.D.), Faculty of Human Life and Environment, Nara Women’s University, Nara, Japan; Infectious Disease Surveillance Cancer (A.Y.), Infectious Disease Research Division, Hyogo Prefectural Institute of Public Health and Environmental Sciences, Hyogo, Japan; Department of Public Health (S.K., A.T.), Aichi Medical University School of Medicine, Aichi, Japan; Department of Epidemiology for Community Health and Medicine (Y.W.), Kyoto Prefectural University of Medicine Graduate School of Medical Sciences; Department of Health and Environmental Sciences (A.K.), Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Medical Informatics and Occupational Epidemiology (Y.W.), Japan Labour Health and Welfare Organization, Kansai Rosai Hospital, Hyogo, Japan; Department of Epidemiology and Environmental Health (Y.I.), Juntendo University School of Medicine, Tokyo, Japan.

Correspondence to Hiroyasu Iso, MD, PhD, Public Health, Department of Social and Environmental Medicine, Osaka University, Graduate School of Medicine, Suita-shi, Osaka 565-0871 Japan. E-mail iso{at}pbhel.med.osaka-u.ac.jp

Background and Purpose— Previous studies have demonstrated the association between alcohol consumption and cardiovascular mortality. However, the sex-specific association between alcohol consumption and mortality from stroke and coronary heart disease remains unclear.

Methods— Between 1988 and 1990, 34 776 men and 48 906 women aged 40 to 79 years completed a self-administered questionnaire including information about alcohol consumption. They were followed-up for a median duration of 14.2 years.

Results— Of the 83 682 respondents, 1628 died from stroke and 736 died from coronary heart disease. For men, heavy drinking (46.0 g ethanol/day) was associated with increased mortality from total, hemorrhagic, and ischemic strokes, whereas light-to-moderate drinking was associated with reduced mortality from total cardiovascular disease, compared with not drinking. The respective multivariable hazard ratios (95% CI) were 1.48 (1.22 to 1.80) for total stoke, 1.67 (1.17 to 2.38) for hemorrhagic stroke, 1.35 (1.04 to 1.75) for ischemic stroke, and 0.88 (0.78 to 1.00) for total cardiovascular disease. Women who were heavy drinkers (46.0 g ethanol/day) showed increased mortality from coronary heart disease, and there was reduced mortality from total cardiovascular disease for drinkers of 0.1 to 22.9 g ethanol per day compared with mortality for nondrinkers. The respective multivariable hazard ratios (95% CI) for the 2 categories of drinkers were 4.10 (1.63 to 10.3) and 0.75 (0.62 to 0.91).

Conclusions— Heavy alcohol consumption is associated with increased mortality from total stroke, particularly hemorrhagic stroke, and total cardiovascular disease for men, and from coronary heart disease for women, whereas light-to-moderate drinking may be associated with reduced mortality from cardiovascular disease for both sexes.

Key Words: alcohol consumption • coronary heart disease • mortality • stroke

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