title: Alcohol consumption and risk of stroke among middle-aged men: the JPHC Study Cohort I.
abstract: OBJECTIVE
  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 > or =450 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, < or =2 drinks per day, does not raise the risk of total stroke.
authors.affiliation: Department of Public Health Medicine, Institute of Community Medicine, University of Tsukuba, 1-1-1 Tennodai, Tuskuba-shi, Ibaraki-ken 305-3985 Japan. fvgh5640@mb.infoweb.ne.jp
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.forename: Shunroku
authors.initials: S
authors.lastname: Baba
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Mannami
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Okada
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Konishi
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Tsugane
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology* / Q000523:psychology; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D002545:Brain Ischemia / Q000453:epidemiology / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D015897:Comorbidity; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology