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Alcohol consumption and mortality in men with preexisting cerebrovascular disease
Vicki A Jackson1, Howard D Sesso, Julie E Buring
1Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA, USA. vjackson@partners.org
Insights
Light to moderate alcohol consumption may reduce the risk of death in men with a history of stroke. Further research is needed to confirm this association between alcohol intake and mortality risks.
Area of Science:
- Cardiovascular Health
- Stroke Recovery
- Epidemiology
Background:
- Limited clinical guidance exists on alcohol consumption risks and benefits for stroke survivors.
- Understanding alcohol's impact on mortality is crucial for patient counseling post-stroke.
Purpose of the Study:
- To investigate the association between alcohol intake levels and the risk of total and cardiovascular mortality in men with a prior stroke.
- To provide data to inform clinical recommendations for stroke patients regarding alcohol consumption.
Main Methods:
- Analysis of 112,528 men from the Physicians' Health Study, including 1320 with a history of stroke.
- Self-reported alcohol consumption categorized into four levels: never, very light, light, and moderate.
- Cox proportional hazards models used to assess mortality risks, adjusted for coronary risk factors.
Main Results:
- A trend towards reduced total mortality (P=.03) and cardiovascular mortality (P=.008) was observed with very light to moderate alcohol intake compared to non-drinkers.
- Relative risks for total mortality ranged from 0.64 to 0.71 for light to moderate drinkers.
- Relative risks for cardiovascular mortality ranged from 0.56 to 0.64 for light to moderate drinkers.
Conclusions:
- Findings suggest a potential inverse relationship between light to moderate alcohol consumption and mortality risks in men with a history of stroke.
- Further investigation is required to validate these preliminary findings and establish definitive conclusions.
Background:
In counseling patients with a history of stroke, clinicians have limited information regarding the risks and benefits of alcohol consumption.
Objective:
To examine the relationship between alcohol intake and risks of total and cardiovascular mortality in men with a history of stroke.
Methods:
The study population consisted of 112 528 men from the enrollment cohort of the Physicians' Health Study, 1320 of whom reported a baseline history of stroke. Men provided self-reported data on alcohol consumption, which was classified into 1 of 4 categories: rarely or never drink, very light (<1 drink per week), light (1-6 drinks per week), or moderate (> or =1 drink per day). Cox proportional hazards models were used to assess the relative risks of mortality associated with alcohol consumption, after adjustment for major coronary risk factors.
Results:
During a mean follow-up of 4(1/2) years, 369 men died, 267 of whom died of cardiovascular disease. Compared with men with a history of stroke who drank rarely or never, those with a very light to moderate alcohol intake had multivariate relative risks for total mortality of 0.88 (95% confidence interval [CI], 0.60-1.28), 0.64 (95% CI, 0.48-0.85), and 0.71 (95% CI, 0.54-0.94), respectively (P =.03 for trend); and relative risks for cardiovascular mortality of 0.89 (95% CI, 0.58-1.36), 0.56 (95% CI, 0.40-0.79), and 0.64 (95% CI, 0.46-0.88) P =.008 for trend). Compared with age-adjusted models, adjustment for major coronary risk factors did not significantly change risk estimates for total or cardiovascular mortality.
Conclusions:
These data indicate a possible inverse association between light to moderate alcohol intake and risks of total and cardiovascular mortality in men with a history of stroke. More data are needed to confirm or refute these results.