Skip to main content
SpringerLink
Log in

Cumulative alcohol consumption and stroke risk in men

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Backgrounds

Views on the relationship between alcohol consumption and stroke risk remain controversial. Moreover, data on cumulative alcohol intake are limited. We examined the potential impact of cumulative alcohol consumption on the risk of total stroke and its subtypes in men.

Methods

This prospective study included 23,433 men from the Kailuan Study. Cumulative alcohol consumption was taken as the primary exposure by calculating self-reported alcohol consumption from three consecutive examinations (in 2006, 2008, and 2010). The first occurrence of stroke was confirmed by reviewing medical records from 2010 to 2016. We used Cox proportional hazards regression to analyze the data.

Results

During the 5.9 ± 0.8 years of follow-up, 678 total strokes were identified, including 595 ischemic stroke (IS), 90 intracerebral hemorrhage and 19 subarachnoid hemorrhage cases. The adjusted hazard ratios (95% confidence intervals) of total stroke for light, moderate and heavy cumulative alcohol consumption were 1.23 (1.01–1.51), 1.49 (1.13–1.97), and 1.50 (1.21–1.86), respectively, compared with those of nondrinkers. The results were similar for IS. Cumulative alcohol consumption was not associated with intracerebral hemorrhage risk (hazard ratio 1.46; 95% confidence interval, 0.74–2.08).

Conclusions

Cumulative alcohol consumption is an independent risk factor of total stroke and IS in men in a community-based cohort. Even light alcohol intake increases the risk of total stroke and IS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, Aboyans V, Adetokunboh O, Afshin A, Agrawal A, Ahmadi A (2017) Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet (Lond Engl) 390(10100):1151–1210

    Article  Google Scholar 

  2. Hay SI, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abdulkader RS, Abdulle AM, Abebo TA, Abera SF, Aboyans V (2017) Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet (Lond Engl) 390(10100):1260–1344

    Article  Google Scholar 

  3. Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, Mensah GA, Norrving B, Shiue I, Ng M, Estep K (2016) Global burden of stroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Neurol 15(9):913–924

    Article  PubMed  Google Scholar 

  4. Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, Barker-Collo S, Moran AE, Sacco RL, Truelsen T, Davis S (2015) Update on the global burden of ischemic and hemorrhagic stroke in 1990–2013: the GBD 2013 Study. Neuroepidemiology 45(3):161–176

    Article  PubMed  PubMed Central  Google Scholar 

  5. WHO (2018) Global status report on alcohol and health 2018. https://www.who.int/substance_abuse/publications/global_alcohol_report/gsr_2018/en/. Accessed 1 May 2019

  6. Berger K, Ajani UA, Kase CS, Gaziano JM, Buring JE, Glynn RJ, Hennekens CH (1999) Light-to-moderate alcohol consumption and the risk of stroke among U.S. male physicians. N Engl J Med 341(21):1557–1564

  7. Smyth A, Teo KK, Rangarajan S, O'Donnell M, Zhang X, Rana P, Leong DP, Dagenais G, Seron P, Rosengren A, Schutte AE (2015) Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study. Lancet (Lond Engl) 386(10007):1945–1954

    Article  CAS  Google Scholar 

  8. Wood AM, Kaptoge S, Butterworth AS, Willeit P, Warnakula S, Bolton T, Paige E, Paul DS, Sweeting M, Burgess S, Bell S, Astle W, Stevens D, Koulman A, Selmer RM, Verschuren WMM, Sato S, Njolstad I, Woodward M, Salomaa V, Nordestgaard BG, Yeap BB, Fletcher A, Melander O, Kuller LH, Balkau B, Marmot M, Koenig W, Casiglia E, Cooper C, Arndt V, Franco OH, Wennberg P, Gallacher J, de la Camara AG, Volzke H, Dahm CC, Dale CE, Bergmann MM, Crespo CJ, van der Schouw YT, Kaaks R, Simons LA, Lagiou P, Schoufour JD, Boer JMA, Key TJ, Rodriguez B, Moreno-Iribas C, Davidson KW, Taylor JO, Sacerdote C, Wallace RB, Quiros JR, Tumino R, Blazer DG 2nd, Linneberg A, Daimon M, Panico S, Howard B, Skeie G, Strandberg T, Weiderpass E, Nietert PJ, Psaty BM, Kromhout D, Salamanca-Fernandez E, Kiechl S, Krumholz HM, Grioni S, Palli D, Huerta JM, Price J, Sundstrom J, Arriola L, Arima H, Travis RC, Panagiotakos DB, Karakatsani A, Trichopoulou A, Kuhn T, Grobbee DE, Barrett-Connor E, van Schoor N, Boeing H, Overvad K, Kauhanen J, Wareham N, Langenberg C, Forouhi N, Wennberg M, Despres JP, Cushman M, Cooper JA, Rodriguez CJ, Sakurai M, Shaw JE, Knuiman M, Voortman T, Meisinger C, Tjonneland A, Brenner H, Palmieri L, Dallongeville J, Brunner EJ, Assmann G, Trevisan M, Gillum RF, Ford I, Sattar N, Lazo M, Thompson SG, Ferrari P, Leon DA, Smith GD, Peto R, Jackson R, Banks E, Di Angelantonio E, Danesh J (2018) Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet 391(10129):1513–1523. https://doi.org/10.1016/s0140-6736(18)30134-x

    Article  PubMed  PubMed Central  Google Scholar 

  9. Zhang C, Qin YY, Chen Q, Jiang H, Chen XZ, Xu CL, Mao PJ, He J, Zhou YH (2014) Alcohol intake and risk of stroke: a dose-response meta-analysis of prospective studies. Int J Cardiol 174(3):669–677. https://doi.org/10.1016/j.ijcard.2014.04.225

    Article  PubMed  Google Scholar 

  10. Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA (2011) Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ (Clin Res Ed) 342:d671. https://doi.org/10.1136/bmj.d671

    Article  Google Scholar 

  11. Jones SB, Loehr L, Avery CL, Gottesman RF, Wruck L, Shahar E, Rosamond WD (2015) Midlife alcohol consumption and the risk of stroke in the atherosclerosis risk in communities study. Stroke 46(11):3124–3130. https://doi.org/10.1161/strokeaha.115.010601

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Yaffe K, Vittinghoff E, Pletcher MJ, Hoang TD, Launer LJ, Whitmer R, Coker LH, Sidney S (2014) Early adult to midlife cardiovascular risk factors and cognitive function. Circulation 129(15):1560–1567. https://doi.org/10.1161/circulationaha.113.004798

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Huang S, Li J, Shearer GC, Lichtenstein AH, Zheng X, Wu Y, Jin C, Wu S, Gao X (2017) Longitudinal study of alcohol consumption and HDL concentrations: a community-based study. Am J Clin Nutr 105(4):905–912. https://doi.org/10.3945/ajcn.116.144832

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Zemaitis P, Liu K, Jacobs DR Jr, Cushman M, Durazo-Arvizu R, Shoham D, Palmas W, Cooper R, Kramer H (2014) Cumulative systolic BP and changes in urine albumin-to-creatinine ratios in nondiabetic participants of the multi-ethnic study of atherosclerosis. Clin J Am Soc Nephrol CJASN 9(11):1922–1929. https://doi.org/10.2215/cjn.02450314

    Article  PubMed  Google Scholar 

  15. McGuire S (2011) U.S. Department of Agriculture and U.S. Department of Health and Human Services, Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, January 2011. Adv Nutr (Bethesda, Md) 2(3):293–294. https://doi.org/10.3945/an.111.000430

    Article  Google Scholar 

  16. Stroke (1989) Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO task force on stroke and other cerebrovascular disorders. Stroke 20(10):1407–1431

  17. Griswold MG, Fullman N, Hawley C, Arian N, Zimsen SR, Tymeson HD, Venkateswaran V, Tapp AD, Forouzanfar MH, Salama JS, Abate KH (2018) Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 392(10152):1015–1035. https://doi.org/10.1016/s0140-6736(18)31310-2

    Article  Google Scholar 

  18. Holmes MV, Dale CE, Zuccolo L, Silverwood RJ, Guo Y, Ye Z, Prieto-Merino D, Dehghan A, Trompet S, Wong A, Cavadino A (2014) Association between alcohol and cardiovascular disease: mendelian randomisation analysis based on individual participant data. BMJ (Clin Res Ed) 349:g4164

    Google Scholar 

  19. Chen CJ, Brown WM, Moomaw CJ, Langefeld CD, Osborne J, Worrall BB, Woo D, Koch S (2017) Alcohol use and risk of intracerebral hemorrhage. Neurology 88(21):2043–2051

    Article  PubMed  PubMed Central  Google Scholar 

  20. Larsson SC, Wallin A, Wolk A, Markus HS (2016) Differing association of alcohol consumption with different stroke types: a systematic review and meta-analysis. BMC Med 14(1):178

    Article  PubMed  PubMed Central  Google Scholar 

  21. Djoussé L, Ellison RC, Beiser A, Scaramucci A, D’Agostino RB, Wolf PA (2002) Alcohol consumption and risk of ischemic stroke: the Framingham Study. Stroke 33(4):907–912

    Article  PubMed  Google Scholar 

  22. De Vocht F, Burstyn I, Sanguanchaiyakrit N (2015) Rethinking cumulative exposure in epidemiology, again. J Eposure Sci Environ Epidemiol 25(5):467–473

    Article  Google Scholar 

  23. Doll R, Hill AB (1950) Smoking and carcinoma of the lung; preliminary report. BMJ 2(4682):739–748

    Article  CAS  PubMed  Google Scholar 

  24. Doll R, Hill AB (1952) A study of the aetiology of carcinoma of the lung. BMJ 2(4797):1271–1286

    Article  CAS  PubMed  Google Scholar 

  25. U.K. Prospective Diabetes Study Group (1995) U.K. prospective diabetes study 16. Overview of 6 years' therapy of type II diabetes: a progressive disease. Diabetes 44(11):1249–1258

  26. Peng M, Wu S, Jiang X, Jin C, Zhang W (2013) Long-term alcohol consumption is an independent risk factor of hypertension development in northern China: evidence from Kailuan study. J Hypertens 31(12):2342–2347. https://doi.org/10.1097/HJH.0b013e3283653999

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Yuxiang Duan and Anxin Wang have contributed equally to the manuscript.

Authors and Affiliations

  1. Department of Neurology, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China

    Yuxiang Duan & Li Yang

  2. Department of Neurology, Tangshan People’s Hospital, No.65 Shengli Road, Lunan District, Tangshan, 063000, Hebei, China

    Yuxiang Duan & Yan Wang

  3. Department of Neurology, Beijing Tiantan Hospital, Dongcheng District, Capital Medical University, No.6 Tiantanxili, Beijing, 100050, China

    Anxin Wang

  4. China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China

    Anxin Wang

  5. Department of Cardiology, Tangshan People’s Hospital, Tangshan, 063000, Hebei, China

    Xizhu Wang

  6. Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, 063000, China

    Shuohua Chen, Quanhui Zhao & Shouling Wu

  7. Department of Psychology, Tangshan People’S Hospital, Tangshan, 063000, Hebei, China

    Xiuling Li

  8. Tianjin Neurological Institute, Tianjin, 300052, China

    Li Yang

Authors
  1. Yuxiang Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anxin Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yan Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xizhu Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shuohua Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Quanhui Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xiuling Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shouling Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Li Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Shouling Wu or Li Yang.

Ethics declarations

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards

This study followed the ethical standards of the Declaration of Helsinki and was approved by the Ethics Committee of Kailuan General Hospital.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 16 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Duan, Y., Wang, A., Wang, Y. et al. Cumulative alcohol consumption and stroke risk in men. J Neurol 266, 2112–2119 (2019). https://doi.org/10.1007/s00415-019-09361-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-019-09361-6

Keywords

Search

Navigation