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Alcohol drinking and risk of hemorrhagic stroke
Arthur L Klatsky1, Mary Anne Armstrong, Gary D Friedman
1Division of Cardiology, Department of Medicine, Kaiser Permanente Medical Center, Oakland, Calif 94611, USA. hartmavn@pacbell.net
Insights
Heavy alcohol consumption shows a weak association with increased hemorrhagic stroke risk. Light to moderate drinking does not appear to elevate this risk, suggesting it need not be avoided solely for hemorrhagic stroke prevention.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Conflicting previous research exists regarding the relationship between alcohol consumption and hemorrhagic stroke (HS).
- Understanding these associations is crucial for public health recommendations and individual risk assessment.
Purpose of the Study:
- To prospectively investigate the association between varying levels of alcohol consumption and the risk of hospitalization for hemorrhagic stroke.
- To clarify the relationship between alcohol intake and specific subtypes of hemorrhagic stroke (subarachnoid and intracerebral hemorrhage).
Main Methods:
- A prospective study involving 431 participants hospitalized for hemorrhagic stroke.
- Alcohol consumption data collected from 128,934 health plan members between 1978-1984.
- Cox proportional hazards models with 6 covariates were used to calculate multivariate relative risks for HS.
Main Results:
- Heavy drinking (6+ drinks/day) was weakly associated with an increased risk of HS (Relative Risk = 1.9, 95% CI: 1.0-3.5).
- Light drinking (<1 drink/day) showed no significant increase in HS risk (Relative Risk = 0.7, 95% CI: 0.5-0.9).
- No independent relationship was found between beverage type (wine, beer, liquor) and HS risk.
Conclusions:
- Only heavy alcohol consumption demonstrates a weak association with increased hemorrhagic stroke risk.
- Light alcohol consumption does not need to be discouraged concerning hemorrhagic stroke risk.
- Findings suggest a nuanced relationship between alcohol intake and hemorrhagic stroke, differentiating between consumption levels.
Abstract:
In view of conflicting prior reports, we prospectively studied associations between alcohol consumption and subsequent hospitalization for hemorrhagic stroke (HS) in 431 persons. Alcohol use was determined at examinations in 1978-1984 among 128,934 members of a prepaid health plan. Cox proportional hazards models, with 6 covariates, yielded the following multivariate relative risks (95% CI's) for HS: lifelong abstainers (ref) = 1.0, exdrinkers = 0.9 (0.5-1.5), persons drinking <1/month = 1.1 (0.8-1.4), >1/month; <1 drink/day = 0.7 (0.5-0.9), 1-2/day = 0.8 (0.6-1.1), 3-5/day = 1.0 (0.6-1.5), 6+/day = 1.9 (1.0-3.5). Relationships to alcohol were similar for subarachnoid (31% of HS) or intracerebral hemorrhage (69% of HS) and in men or women. Beverage choice (wine, beer, and liquor) was not independently related. We conclude that only heavy drinking is weakly related to increased HS risk and that light drinking need not be proscribed with respect to HS risk.