Alcohol consumption and risk of stroke among middle-aged men: The JPHC Study Cohort I
Alcohol consumption and risk of stroke among middle-aged men: The JPHC Study Cohort I
复制标题
DOI：
10.1161/01.str.0000124459.33597.00
复制
发表时间：
2004-05-01
期刊：
影响因子：
8.3
通讯作者：
Tsugane, S
中科院分区：
文献类型：
--
作者：
Iso, H;Baba, S;Tsugane, S
背景和目的——尽管meta分析假设不同的中风亚型之间的影响有所不同，但在单一研究中尚未对轻度至中度饮酒对中风风险的影响进行过很好的研究。方法-在日本公共卫生中心癌症和心血管疾病前瞻性研究（JPHC研究）中，从1990年至1992年至2001年底，共有19544名年龄在40至59岁之间居住在社区的男性进行了随访。结果：经过214504人年的随访，记录了694例中风事件，其中611例通过影像学检查或尸检证实，包括219例肺实质出血，73例蛛网膜下腔出血和319例缺血性中风。饮酒与年龄调整后的总卒中风险呈正相关，与偶尔饮酒者相比，每周酒精摄入量大于或等于450克的饮酒者卒中风险高出68%。这种额外的风险主要局限于出血性中风，即使在控制了高血压和其他心血管危险因素后，这一风险仍然具有统计学意义（RR: 2.15; 95% CI: 1.22至3.79）。与偶尔饮酒者相比，每周饮用1 - 149 g乙醇的饮酒者发生缺血性卒中的风险较低，更具体地说，是腔隙性梗死，出血性卒中的风险较高，并且卒中总风险没有增加；各自的多变量RR （95% CI）分别为0.59（0.37 ~ 0.93）、0.43（0.22 ~ 0.87）、1.73（0.98 ~ 3.07）和0.98（0.71 ~ 1.36）。结论：我们发现轻度和中度饮酒对中年男性出血性和缺血性中风风险的不同影响。轻度至中度饮酒，即每天少于或等于2杯，不会增加总卒中的风险。
Background and Purpose - The impact of light-to-moderate alcohol consumption on risk of stroke has not been well examined in a single study, although the effect is hypothesized to differ among stroke subtypes from meta-analyses.Methods - A total of 19 544 men aged 40 to 59 years living in communities were followed-up from 1990 to 1992 to the end of 2001 in the Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Disease (JPHC Study).Results - After 214 504 person-years of follow-up, 694 incident strokes were documented, of which 611 were confirmed by imaging studies or autopsy, including 219 intraparenchymal hemorrhages, 73 subarachnoid hemorrhages, and 319 ischemic strokes. Alcohol consumption was positively associated with age-adjusted risk of total stroke with a 68% excess risk among drinkers of greater than or equal to450 g ethanol per week compared with occasional drinkers. This excess risk was confined primarily to hemorrhagic stroke, which remained statistically significant even after controlling for hypertension and other cardiovascular risk factors (RR: 2.15; 95% CI: 1.22 to 3.79). There was a lower risk of ischemic stroke, more specifically lacunar infarction, a higher risk of hemorrhagic stroke, and no excess risk of total stroke among drinkers of 1 to 149 g ethanol per week compared with occasional drinkers; the respective multivariate RR ( 95% CI) was 0.59 (0.37 to 0.93), 0.43 (0.22 to 0.87), 1.73 (0.98 to 3.07), and 0.98 (0.71 to 1.36).Conclusions - We found differential effects of light-to-moderate alcohol consumption on risks of hemorrhagic and ischemic strokes among middle-aged men. Light-to-moderate alcohol consumption, ie, less than or equal to2 drinks per day, does not raise the risk of total stroke.