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El consumo de alcohol y la incidencia de accidentes cerebrovasculares en hombres fumadores
J M Leppälä1, M Paunio, J Virtamo
1Department of Public Health, University of Helsinki, Finland. jaana.leppala@helsinki.fi
Circulation
|September 14, 1999
Resumen
El consumo excesivo de alcohol aumenta el riesgo de accidente cerebrovascular, en particular la hemorragia subaracnoidea. El consumo moderado de alcohol también puede elevar los riesgos de ciertos tipos de accidente cerebrovascular. La presión arterial y el colesterol HDL parecen influir en estos riesgos de accidente cerebrovascular relacionados con el alcohol.
Área de la Ciencia:
- Neurología Neurología.
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Epidemiología La epidemiología.
Sus antecedentes:
- La relación del consumo de alcohol con los subtipos de accidente cerebrovascular no se entiende completamente.
- Mecanismos como la presión arterial y el colesterol HDL median el efecto del alcohol en las enfermedades del corazón, pero no claramente para las enfermedades cerebrovasculares.
Objetivo del estudio:
- Investigar la relación dosis-respuesta entre el consumo de alcohol y el riesgo de diferentes subtipos de ictus en hombres fumadores.
- Explorar las funciones mediadoras de la presión arterial sistólica y el colesterol HDL en el efecto del alcohol en la incidencia del accidente cerebrovascular.
Principales métodos:
- Un estudio de cohorte de 26.556 hombres fumadores de 50 a 69 años sin accidente cerebrovascular previo.
- Los participantes fueron categorizados por la ingesta de alcohol: no bebedores, ligeros (<=24 g/d), moderados (25-60 g/d), y pesados (>60 g/d).
- Se calcularon los riesgos relativos ajustados para los subtipos de accidente cerebrovascular (hemorragia subaracnoidea, hemorragia intracerebral, infarto cerebral).
Principales resultados:
- El consumo excesivo de alcohol se asoció con un mayor riesgo de hemorragia subaracnoidea (RR 1.6) e infarto cerebral (RR 1.5).
- El consumo moderado de alcohol mostró un mayor riesgo de hemorragia subaracnoidea (RR 1.3) e infarto cerebral (RR 1.2).
- La presión arterial sistólica atenuó el efecto del alcohol en todos los subtipos de ictus, mientras que el colesterol HDL tuvo efectos variados dependiendo del tipo de ictus.
Conclusiones:
- El consumo de alcohol exhibe patrones de dosis-respuesta distintos para los subtipos de accidente cerebrovascular: lineal para la hemorragia subaracnoidea, en forma de U para la hemorragia intracerebral, y en forma de J para el infarto cerebral.
- La presión arterial sistólica y el colesterol HDL parecen mediar el impacto del alcohol en el accidente cerebrovascular, lo que sugiere mecanismos subyacentes adicionales.
- Se necesita más investigación para aclarar completamente estas relaciones.
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