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Alcohol use and subsequent cerebrovascular disease hospitalizations
A L Klatsky1, M A Armstrong, G D Friedman
1Department of Medicine, Kaiser Permanente Medical Center, Oakland, CA 94611-5693.
Insights
Heavy alcohol consumption increases the risk of hemorrhagic cerebrovascular disease. However, alcohol use may reduce the risk of occlusive cerebrovascular disease, suggesting differential effects on stroke types.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Cerebrovascular diseases encompass both hemorrhagic and occlusive subtypes.
- The relationship between alcohol consumption and different stroke types requires further elucidation.
Purpose of the Study:
- To investigate the association between reported alcohol use and hospitalization rates for various cerebrovascular diseases.
- To identify independent predictors for hemorrhagic and occlusive cerebrovascular events.
Main Methods:
- Retrospective cohort study analyzing reported alcohol consumption.
- Examined hospitalization incidence for hemorrhagic and occlusive cerebrovascular diseases.
- Statistical analysis controlled for age, blood pressure, race, smoking, and metabolic factors.
Main Results:
- Daily consumption of three or more alcoholic drinks was linked to increased hospitalization for hemorrhagic cerebrovascular disease, particularly intracerebral hemorrhage.
- Higher blood pressure partially mediated the alcohol-hemorrhagic event association.
- Alcohol consumption showed an inverse relationship with hospitalization for occlusive cerebrovascular disease across demographics and lesion locations.
- Age, blood pressure, smoking, blood glucose, and cholesterol were also predictors of occlusive disease.
Conclusions:
- Heavier alcohol intake elevates the risk of hemorrhagic stroke.
- Moderate alcohol consumption might offer a protective effect against occlusive stroke.
- Understanding these differential risks is crucial for public health recommendations regarding alcohol and stroke prevention.
Abstract:
We studied the relations between reported alcohol use and the incidence of hospitalization for several types of cerebrovascular disease. Daily consumption of three or more drinks, but not lighter drinking, was related to higher hospitalization rates for hemorrhagic cerebrovascular disease, especially intracerebral hemorrhage. Age, blood pressure, and black race were other independent predictors of hemorrhagic events; higher blood pressure appeared to be a partial mediator of the relation between alcohol use and hemorrhagic events. Alcohol use was associated with lower hospitalization rates for occlusive cerebrovascular disease; an inverse relation was present in both sexes, whites and blacks, and for extracranial and intracerebral occlusive lesions. Other predictors of hospitalization for occlusive disease included age, blood pressure, smoking, blood glucose and total cholesterol concentrations, and baseline disease. Our data suggest that heavier drinking increases the risk of hemorrhagic cerebrovascular events, but that alcohol use may lessen the risk of occlusive lesions.