Mukamal Kenneth J, Ascherio Alberto, Mittleman Murray A, Conigrave Katherine M, Camargo Carlos A, Kawachi Ichiro, Stampfer Meir J, Willett Walter C, Rimm Eric B
Beth Israel Deaconess Medical Center, Harvard School of Public Health, Massachusetts General Hospital, and Brigham and Women's Hospital, Boston, Massachusetts 02215, USA.
Ann Intern Med. 2005 Jan 4;142(1):11-9. doi: 10.7326/0003-4819-142-1-200501040-00007.
The association of light to moderate alcohol consumption with risk for ischemic stroke remains controversial, as do the roles of beverage type and drinking pattern.
To assess the association of drinking patterns and beverage type with risk for ischemic stroke among men.
Prospective cohort study.
United States.
38 156 male health professionals who were free of known cardiovascular disease or cancer at baseline in 1986.
With a semi-quantitative food-frequency questionnaire, the authors individually ascertained consumption of regular and light beer, red and white wine, and liquor every 4 years. Alcohol consumption was categorized as light (0.1 to 9.9 g/d, or <1 drink daily), moderate (10.0 to 29.9 g/d, or 1 to 2 drinks daily), and heavier (> or =30.0 g/d, or > or =3 drinks daily).
During a follow-up period of 14 years, 412 cases of incident ischemic stroke were documented. Compared with abstainers, light drinkers had a multivariate-adjusted relative risk of 0.99 (95% CI, 0.72 to 1.37), moderate drinkers had a multivariate-adjusted relative risk of 1.26 (CI, 0.90 to 1.76), and heavier drinkers had a multivariate-adjusted relative risk of 1.42 (CI, 0.97 to 2.09; P = 0.01 for trend). Consumption of 10.0 to 29.9 g of alcohol per day on 3 to 4 days per week appeared to be associated with the lowest risk (relative risk, 0.68 [CI, 0.44 to 1.05]). Red wine consumption was inversely associated with risk in a graded manner (P = 0.02 for trend), but other beverages were not. The apparently higher risk for ischemic stroke with heavier alcohol use appeared to be most pronounced for the embolic subtype.
This study had limited power to examine specific drinking patterns and heavy drinking and could not assess risk for hemorrhagic stroke.
In this sample of male health professionals, light and moderate average alcohol use was generally not associated with an increased risk for ischemic stroke, although drinking pattern and beverage type modified this relation. Intake of more than 2 drinks per day may be associated with a higher risk for ischemic stroke.
轻度至中度饮酒与缺血性中风风险之间的关联仍存在争议，饮料类型和饮酒模式的作用也同样如此。
评估男性饮酒模式和饮料类型与缺血性中风风险之间的关联。
前瞻性队列研究。
美国。
38156名男性健康专业人员，他们在1986年基线时没有已知的心血管疾病或癌症。
作者使用半定量食物频率问卷，每4年分别确定常规啤酒、淡啤酒、红酒、白酒和烈酒的摄入量。酒精摄入量分为轻度（0.1至9.9克/天，或每天少于1杯）、中度（10.0至29.9克/天，或每天1至2杯）和重度（≥30.0克/天，或≥每天3杯）。
在14年的随访期内，记录了412例缺血性中风新发病例。与戒酒者相比，轻度饮酒者的多变量调整相对风险为0.99（95%置信区间，0.72至1.37），中度饮酒者的多变量调整相对风险为1.26（置信区间，0.90至1.76），重度饮酒者的多变量调整相对风险为1.42（置信区间，0.97至2.09；趋势P = 0.01）。每周3至4天每天摄入10.0至29.9克酒精似乎与最低风险相关（相对风险，0.68 [置信区间，0.44至1.05]）。红酒消费与风险呈分级负相关（趋势P = 0.02），但其他饮料则不然。重度饮酒导致的缺血性中风风险明显升高似乎在栓塞亚型中最为明显。
本研究检验特定饮酒模式和重度饮酒的能力有限，且无法评估出血性中风风险。
在这个男性健康专业人员样本中，尽管饮酒模式和饮料类型改变了这种关系，但轻度和中度平均饮酒通常与缺血性中风风险增加无关。每天饮酒超过2杯可能与缺血性中风风险较高有关。
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