Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham.
J Gerontol B Psychol Sci Soc Sci. 2018 Apr 16;73(4):636-648. doi: 10.1093/geronb/gbw153.
This study examines the relationship between alcohol consumption and incident stroke among older adults and tests whether alcohol consumption contributes to observed race and sex differences in stroke.
Data are from a U.S. national cohort of black and white adults aged 45 and older, the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Current and past drinking levels were reported at baseline (2003-2007). Participants who had never had a stroke were followed for adjudicated stroke events through September 2015 (n = 27,265). We calculated Cox proportional hazard models for stroke, adjusting for demographic, socioeconomic, behavioral, and health characteristics.
Participants, mean age 64.7 years, consumed on average 2.2 drinks/week and experienced 1,140 first-time stroke events over median 9.1 years follow-up. Nondrinkers had a 12% higher risk of stroke than current drinkers; the risk of stroke among nondrinkers largely reflected high risks among past drinkers; these differences were explained by socioeconomic characteristics. Among current drinkers, light drinkers had significantly lower stroke risks than moderate drinkers after accounting for demographic, socioeconomic, behavioral, and health characteristics. Implications of alcohol did not differ between blacks and whites but did differ by sex: Especially among women, nondrinkers, and specifically past drinkers, had higher risks; these differences were largely explained by health characteristics and behaviors. Alcohol did not explain race and sex differences in stroke incidence.
Among older adults, those who used to, but no longer, drink had higher risks of stroke, especially among women; current light drinkers had the lowest risk of stroke.
本研究旨在探讨老年人饮酒与中风事件之间的关系,并检验饮酒是否导致中风在不同种族和性别之间的观察到的差异。
本研究的数据来自美国一个由年龄在 45 岁及以上的黑人和白人成年人组成的全国队列,即地理和种族差异导致中风的原因(REGARDS)研究。在基线(2003-2007 年)时报告了当前和过去的饮酒水平。在 2015 年 9 月之前,对没有发生过中风的参与者进行了中风事件的裁决后随访(n=27265)。我们计算了中风的 Cox 比例风险模型,调整了人口统计学、社会经济、行为和健康特征。
参与者的平均年龄为 64.7 岁,平均每周饮酒 2.2 次,在中位 9.1 年的随访期间经历了 1140 例首次中风事件。不饮酒者的中风风险比当前饮酒者高 12%;不饮酒者的中风风险主要反映了过去饮酒者的高风险;这些差异可以用社会经济特征来解释。在当前饮酒者中,在考虑了人口统计学、社会经济、行为和健康特征后,轻度饮酒者的中风风险明显低于中度饮酒者。酒精的影响在黑人和白人之间没有差异,但在性别之间存在差异:尤其是在女性中,不饮酒者,特别是过去饮酒者,中风风险更高;这些差异在很大程度上可以用健康特征和行为来解释。酒精并不能解释中风发病率在不同种族和性别的差异。
在老年人中,那些曾经饮酒但现在不饮酒的人中风风险更高,尤其是女性;当前轻度饮酒者中风风险最低。