Abstract
Background:
The relationship between alcohol use and stroke is complex. A U-shaped relationship has been identified for ischemic stroke, while a more linearly increasing risk has been found for hemorrhagic stroke. Previous investigations of alcohol and risk on hemorrhagic stroke have not consistently reported on the separate risk of intracerebral hemorrhage (ICH). We here report on the association of alcohol use and risk of ICH in ERICH.
Methods:
ERICH is a multi-center, prospective, case-control study of a race-ethnically mixed population with ICH. Controls were identified through random digit dialing to match cases by age (+/- 5 years), sex, race/ethnicity (non-Hispanic white, non-Hispanic black and Hispanic) and geographic area. Records of cases were reviewed for past medical history and data on ICH presentation. All cases and controls underwent a comprehensive interview which includes questions regarding alcohol use. We categorized alcohol use as none, rare (<1 drink a month), moderate ( ≥1 drink per month and ≤2 drinks daily), intermediate (>2 but <5 daily) and heavy (≥ 5 daily). Odds ratios for each category were calculated using the no use alcohol group as a reference.
Results:
A total of 740 cases were matched with controls. Mean age was 58±12, 55% were male, 44% non-Hispanic black, 31% non-Hispanic white and 25% Hispanic. Cases were more likely to report no (52 vs. 37%) and heavy alcohol use (12% vs. 5.2%). Controls were more likely to report rare (12 vs. 6%), moderate (41 vs. 26%) and intermediate (5 vs. 4%) alcohol use. The odds ratios were 0.47 (CI: 0.27-0.82) for rare, 0.58 (CI: 0.40-0.83) for moderate, 0.57 (CI: 0.27-1.19) for intermediate and 1.54 (CI: 0.87-2.72) for heavy use after adjustment for baseline group differences.
Conclusion:
These findings demonstrate a protective effect of rare and moderate alcohol use on ICH risk in a multi racial-ethnic population. There was a non-significant trend for heavy alcohol use and increasing ICH risk. The results support previous recommendations on the moderate use of alcohol and cardiovascular disease prevention.