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Cited by 203Alcohol Consumption and Health EffectsAcute Ischemic Stroke ManagementSubstance Abuse Treatment and Outcomes

Alcohol intake and risk of stroke: a dose-response meta-analysis of prospective studies

Zhang, Chi, Qin, Ying-Yi, Chen, Qi, Jiang, Hong, Chen, Xian-Zhen, Xu, Chun-Li, Mao, Pei-Juan, He, Jia +1 more·2014·International Journal of Cardiology
DOI 10.1016/j.ijcard.2014.04.225
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Abstract

Background Alcohol intake is inconsistently associated with the risk of stroke morbidity and mortality. The purpose of this study was to summarize the evidence regarding this relationship by using a dose-response meta-analytic approach.Methods We performed electronic searches of PubMed, EMBASE, and the Cochrane Library to identify relevant prospective studies. Only prospective studies that reported effect estimates with 95% confidence intervals (CIs) of stroke morbidity and mortality for more than 2 categories of alcohol intake were included.Results We included 27 prospective studies reporting data on 1,425,513 individuals. Low alcohol intake was associated with a reduced risk of total stroke (risk ratio [RR], 0.85; 95% CI: 0.75-0.95; P=0.005), ischemic stroke (RR, 0.81; 95% CI: 0.74-0.90; P<0.001), and stroke mortality (RR, 0.67; 95% CI: 0.53-0.85; P=0.001), but it had no significant effect on hemorrhagic stroke. Moderate alcohol intake had little or no effect on the risks of total stroke, hemorrhagic stroke, ischemic stroke, and stroke mortality. Heavy alcohol intake was associated with an increased risk of total stroke (RR, 1.20; 95% CI: 1.01-1.43; P=0.034), but it had no significant effect on hemorrhagic stroke, ischemic stroke, and stroke mortality.Conclusions Low alcohol intake is associated with a reduced risk of stroke morbidity and mortality, whereas heavy alcohol intake is associated with an increased risk of total stroke. The association between alcohol intake and stroke morbidity and mortality is J-shaped.

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  • In men, greatest protection from CHD was at 31 g/d, with increased risk beginning at 63 g/d.

    “In a dose-response meta-analysis of 24 prospective cohort studies (275), the association of drinking with CHD was J-shaped: non-drinkers were at slightly increased risk; in men the greatest protection was at 31 g/d with a trend for increased risk beginning at 63 g/d; for women, the greatest protection was at 11 g/d with a trend for increased risk beginning at 14 g/d.”

    From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [275]

  • In women, greatest protection from CHD was at 11 g/d, with increased risk beginning at 14 g/d.

    “In a dose-response meta-analysis of 24 prospective cohort studies (275), the association of drinking with CHD was J-shaped: non-drinkers were at slightly increased risk; in men the greatest protection was at 31 g/d with a trend for increased risk beginning at 63 g/d; for women, the greatest protection was at 11 g/d with a trend for increased risk beginning at 14 g/d.”

    From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [275]

  • In a dose-response meta-analysis, the association of drinking with CHD was J-shaped.

    “In a dose-response meta-analysis of 24 prospective cohort studies (275), the association of drinking with CHD was J-shaped: non-drinkers were at slightly increased risk; in men the greatest protection was at 31 g/d with a trend for increased risk beginning at 63 g/d; for women, the greatest protection was at 11 g/d with a trend for increased risk beginning at 14 g/d.”

    From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [275]

  • In a meta-analysis, no association between light/moderate alcohol use and stroke.

    “In a meta-analysis of 27 prospective studies of alcohol and stroke, no association was found between light or moderate alcohol use and stroke, but heavy alcohol use (>45 g/d) was shown to increase total stroke risk (RR: 1.20; 95% CI: 1.01 to 1.43), particularly hemorrhagic stroke (RR: 1.29; 95% CI: 0.98 to 1.71) (275).”

    From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [275]

  • Heavy alcohol use (>45 g/d) increased total stroke risk (RR 1.20, 95% CI 1.01-1.43), particularly hemorrhagic stroke (RR 1.29, 95% CI 0.98-1.71).

    “In a meta-analysis of 27 prospective studies of alcohol and stroke, no association was found between light or moderate alcohol use and stroke, but heavy alcohol use (>45 g/d) was shown to increase total stroke risk (RR: 1.20; 95% CI: 1.01 to 1.43), particularly hemorrhagic stroke (RR: 1.29; 95% CI: 0.98 to 1.71) (275).”

    From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [275]

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Authors
Zhang, C., Qin, Y.-Y., Chen, Q., Jiang, H., Chen, X.-Z., Xu, C.-L., Mao, P.-J., He, J., & Zhou, Y.-H.
Affiliations
  • Seventh People's Hospital of Shanghai (CN)
  • Second Military Medical University (CN)
Corresponding author
He, Jia
ORCID
Venue
International Journal of Cardiology
Publisher
Elsevier BV
Published
2014-07
Volume
174
Issue
3
Pages
669-677
ISSN
0167-5273 (ISSN-L)
DOI
10.1016/j.ijcard.2014.04.225
OpenAlex
W2090134184
Cited by
203
References
58
Citations by year
2026: 7 · 2025: 22 · 2024: 18 · 2023: 17 · 2022: 19 · 2021: 29 · 2020: 19 · 2019: 15 · 2018: 18 · 2017: 9 · 2016: 16 · 2015: 10 · 2014: 2
FWCI
1.75
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • International Journal of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
alcohol consumption, stroke, ischemic stroke, hemorrhagic stroke, stroke mortality, dose-response relationship, heavy drinking, moderate drinking, J-shaped association
MeSH terms
Alcohol Drinking, Ethanol, Alcoholic Beverages, Dose-Response Relationship, Drug, Humans, Prospective Studies, Risk Factors, Cohort Studies, Stroke

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