Alcohol use and risk of intracerebral hemorrhage
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Abstract
Objective: To analyze the dose–risk relationship for alcohol consumption and intracerebral hemorrhage (ICH) in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study.
Methods: ERICH is a multicenter, prospective, case-control study, designed to recruit 1,000 non-Hispanic white patients, 1,000 non-Hispanic black patients, and 1,000 Hispanic patients with ICH. Cases were matched 1:1 to ICH-free controls by age, sex, race/ethnicity, and geographic area. Comprehensive interviews included questions regarding alcohol consumption. Patterns of alcohol consumption were categorized as none, rare (<1 drink per month), moderate (≥1 drink per month and ≤2 drinks per day), intermediate (>2 drinks per day and <5 drinks per day), and heavy (≥5 drinks per day). ICH risk was calculated using the no-alcohol use category as the reference group.
Results: Multivariable analyses demonstrated an ordinal trend for alcohol consumption: rare (odds ratio [OR] 0.57, p < 0.0001), moderate (OR 0.65, p < 0.0001), intermediate (OR 0.82, p = 0.2666), and heavy alcohol consumption (OR 1.77, p = 0.0003). Subgroup analyses demonstrated an association of rare and moderate alcohol consumption with decreased risk of both lobar and nonlobar ICH. Heavy alcohol consumption demonstrated a strong association with increased nonlobar ICH risk (OR 2.04, p = 0.0003). Heavy alcohol consumption was associated with significant increase in nonlobar ICH risk in black (OR 2.34, p = 0.0140) and Hispanic participants (OR 12.32, p < 0.0001). A similar association was not found in white participants.
Conclusions: This study demonstrated potential protective effects of rare and moderate alcohol consumption on ICH risk. Heavy alcohol consumption was associated with increased ICH risk. Race/ethnicity was a significant factor in alcohol-associated ICH risk; heavy alcohol consumption in black and Hispanic participants poses significant nonlobar ICH risk.
GLOSSARY
- BMI=
- body mass index;
- BP=
- blood pressure;
- CAD=
- coronary artery disease;
- CI=
- confidence interval;
- DM=
- diabetes mellitus;
- ERICH=
- Ethnic/Racial Variations of Intracerebral Hemorrhage;
- HDL=
- high-density lipoprotein;
- ICH=
- intracerebral hemorrhage;
- INR=
- international normalized ratio;
- LDL=
- low-density lipoprotein;
- MI=
- myocardial infarction;
- mRS=
- modified Rankin Scale;
- OR=
- odds ratio;
- PT=
- prothrombin time;
- PTT=
- partial thromboplastin time;
- RR=
- relative risk
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received September 1, 2016.
- Accepted in final form March 1, 2017.
- © 2017 American Academy of Neurology
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