title: Alcohol consumption and stroke mortality. 20-year follow-up of 15,077 men and women.
abstract: OBJECTIVE
  Since stroke is a principal cause of death in elderly people, we analyzed the association between alcohol and stroke mortality in a cohort of 15,077 middle-aged and older men and women.
  
  
  METHODS
  Data on alcohol habits were obtained from a questionnaire in 1967. The subsequent 20 years yielded 769 deaths from stroke, of which 574 were ischemic. Relative mortality risks (RR) were estimated from logistic regression analyses with lifelong alcohol abstainers as a reference group. Adjustments were made for age and smoking.
  
  
  RESULTS
  No association was found between alcohol intake and hemorrhagic stroke. An elevated risk of ischemic stroke was found for men who drank infrequently, that is, a few times a year or less often (RR, 2.0; 95% confidence interval [CI], 1.3 to 3.2), for those who were intoxicated now and then (RR, 1.8; 95% CI, 1.1 to 2.8), and for those who reported "binge" drinking a few times in the year or less often (RR, 1.6; 95% CI, 1.1 to 2.5). Among women only ex-drinkers had an elevated risk of dying of ischemic stroke (RR, 3.3; 95% CI, 1.5 to 7.2). The risk was reduced for women who had an estimated average consumption of 0 to 5 g pure alcohol per day (RR, 0.6; 95% CI, 0.5 to 0.8); for those who did not drink every day (RR, 0.7; 95% CI, 0.5 to 0.9); and for those who never "went on a binge" (RR, 0.6; 95% CI, 0.5 to 0.8) or became intoxicated (RR, 0.7; 95% CI, 0.5 to 0.9).
  
  
  CONCLUSIONS
  Drinking habits were associated only with deaths from ischemic stroke, and the risk patterns were different for men and women. In analyses, ex-drinkers should not be included with lifelong abstainers, since the former tend to run high health risk.
authors.affiliation: Karolinska Institute, Psychiatric Clinic for Alcohol and Drug Dependence, St Göran's Hospital, Stockholm, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Hansagi
authors.forename: A
authors.initials: A
authors.lastname: Romelsjö
authors.forename: M
authors.initials: M
authors.lastname: Gerhardsson de Verdier
authors.forename: S
authors.initials: S
authors.lastname: Andréasson
authors.forename: A
authors.initials: A
authors.lastname: Leifman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D000435:Alcoholic Intoxication / Q000453:epidemiology; D002545:Brain Ischemia / Q000401:mortality; D002543:Cerebral Hemorrhage / Q000401:mortality; D002561:Cerebrovascular Disorders / Q000401:mortality*; D015331:Cohort Studies; D000431:Ethanol / Q000008:administration & dosage / Q000506:poisoning; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D013695:Temperance; D018433:Twin Studies as Topic
chemical_list: D000431:Ethanol