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Martinez-Majander N, Kutal S, Ylikotila P, Yesilot N, Tulkki L, Zedde M, Sarkanen T, Junttola U, Nordanstig A, Fromm A, Ryliskiene K, Licenik R, Ferdinand P, Jatuzis D, Kõrv L, Kõrv J, Pezzini A, Tuohinen S, Sinisalo J, Lehto M, Gerdts E, Ryödi E, Autere J, Hedman M, Fonseca AC, Waje-Andreassen U, von Sarnowski B, Redfors P, Sairanen T, Tatlisumak T, Roine RO, Huhtakangas J, Numminen H, Jäkälä P, Putaala J. Association between heavy alcohol consumption and cryptogenic ischaemic stroke in young adults: a case-control study. J Neurol Neurosurg Psychiatry 2024:jnnp-2024-333759. [PMID: 38906694 DOI: 10.1136/jnnp-2024-333759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/05/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND The underlying risk factors for young-onset cryptogenic ischaemic stroke (CIS) remain unclear. This multicentre study aimed to explore the association between heavy alcohol consumption and CIS with subgroup analyses stratified by sex and age. METHODS Altogether, 540 patients aged 18-49 years (median age 41; 47.2% women) with a recent CIS and 540 sex-matched and age-matched stroke-free controls were included. Heavy alcohol consumption was defined as >7 (women) and >14 (men) units per week or at least an average of two times per month ≥5 (women) and ≥7 (men) units per instance (binge drinking). A conditional logistic regression adjusting for age, sex, education, hypertension, cardiovascular diseases, diabetes, hypercholesterolaemia, current smoking, obesity, diet and physical inactivity was used to assess the independent association between alcohol consumption and CIS. RESULTS Patients were twice as more often heavy alcohol users compared with controls (13.7% vs 6.7%, p<0.001), were more likely to have hypertension and they were more often current smokers, overweight and physically inactive. In the entire study population, heavy alcohol consumption was independently associated with CIS (adjusted OR 2.11; 95% CI 1.22 to 3.63). In sex-specific analysis, heavy alcohol consumption was associated with CIS in men (2.72; 95% CI 1.25 to 5.92), but not in women (1.56; 95% CI 0.71 to 3.41). When exploring the association with binge drinking alone, a significant association was shown in the entire cohort (2.43; 95% CI 1.31 to 4.53) and in men (3.36; 95% CI 1.44 to 7.84), but not in women. CONCLUSIONS Heavy alcohol consumption, particularly binge drinking, appears to be an independent risk factor in young men with CIS.
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Affiliation(s)
| | - Shakar Kutal
- Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Pauli Ylikotila
- Department of Neurology, Neurocenter, Turku University Hospital, University of Turku, Turku, Finland
| | - Nilufer Yesilot
- Department of Neurology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Lauri Tulkki
- Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marialuisa Zedde
- Neurology, Azienda Ospedaliera Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Tomi Sarkanen
- Department of Neurology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Ulla Junttola
- Clinical Neuroscience Research Unit and Department of Neurology, Oulu University Hospital, Oulu, Finland
| | - Annika Nordanstig
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Annette Fromm
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | | | - Radim Licenik
- Stroke, Peterborough City Hospital, Peterborough, UK
| | - Phillip Ferdinand
- Neurosciences, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Dalius Jatuzis
- Centre of Neurology, Vilnius University, Vilnius, Lithuania
| | - Liisa Kõrv
- Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia
| | - Janika Kõrv
- Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia
| | - Alessandro Pezzini
- Department of Medicine and Surgery, University of Parma and Stroke Care Program, Department of Emergency, Parma University Hospital, Parma, Italy
| | - Suvi Tuohinen
- Department of Cardiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Juha Sinisalo
- Department of Cardiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mika Lehto
- Department of Internal Medicine, Jorvi Hospital, HUS Helsinki University Hospital, Helsinki Finland, and University of Helsinki, Helsinki, Finland
| | - Eva Gerdts
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Essi Ryödi
- Tampere Heart Hospital, Tampere University Hospital, Tampere, Finland
| | - Jaana Autere
- Neurocenter Neurology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Marja Hedman
- Heart Centre, Kuopio University Hospital, Kuopio, Finland
| | - Ana Catarina Fonseca
- Department of Neurosciences and Mental Health (Neurology), Hospital de Santa Maria-CHLN, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | | | | | - Petra Redfors
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tiina Sairanen
- Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Turgut Tatlisumak
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Risto O Roine
- Department of Neurology, Neurocenter, Turku University Hospital, University of Turku, Turku, Finland
| | - Juha Huhtakangas
- Clinical Neuroscience Research Unit and Department of Neurology, Oulu University Hospital, Oulu, Finland
| | - Heikki Numminen
- Department of Neurology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Pekka Jäkälä
- Neurocenter Neurology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Jukka Putaala
- Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Zhang H, Chang Y, Li Y, Wei J, Ma X, Zhou W, Zang X, Jin T, Wu S. Effects of CASZ1, WNT2B and PTPRG SNPs on stroke susceptibility in the Chinese Han population. Eur J Clin Invest 2024; 54:e14144. [PMID: 38059696 DOI: 10.1111/eci.14144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/20/2023] [Accepted: 11/19/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Stroke is an important cause of death and disability worldwide, ranking second in the cause of death, and it is thought to be related to genetic factors. The purpose of our study is to investigate the association between CASZ1, WNT2B and PTPRG single nucleotide polymorphisms (SNPs) and stroke risk in the Chinese population. METHODS We recruited 1418 volunteers, comprised of 710 stroke cases and 708 controls in this study. We used MassARRAY iPLEX GOLD method to genotype the three SNPs on CASZ1, WNT2B and PTPRG. Logistic regression was used to analyse the association between these SNPs and stroke, and odds ratios (ORs) and 95% confidence intervals (CIs) were then calculated. What's more, the interactions among SNPs were predicted by multi-factor dimensionality reduction (MDR) analysis. RESULTS This research demonstrated that CASZ1 rs880315 and PTPRG rs704341 were associated with reduced stroke susceptibility. More precisely, CASZ1 rs880315 was associated with reduced stroke susceptibility in people aged ≤64 years and women. PTPRG rs704341 was associated with reduced stroke susceptibility in people aged >64 years, women, non-smokers and non-drinkers. Conversely, WNT2B rs12037987 was related to elevated stroke susceptibility in people aged >64 years, women and non-smokers. In addition, CASZ1 rs880315, WNT2B rs12037987 and PTPRG rs704341 had a strong redundancy relationship. CONCLUSION Our study concludes that CASZ1 rs880315, WNT2B rs12037987 and PTPRG rs704341 are associated with stroke, and the study provides a basis for assessing genetic variants associated with stroke risk in the Han Chinese population.
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Affiliation(s)
- Huan Zhang
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
- Department of Neurology, The First Hospital of Xi'an, The First Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Yanting Chang
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
- Department of Neurology, The First Hospital of Xi'an, The First Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Yujie Li
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
| | - Jie Wei
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
| | - Xiaoya Ma
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
| | - Wenqian Zhou
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
| | - Xufeng Zang
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
| | - Tianbo Jin
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
| | - Songdi Wu
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Department of Neurology, The First Hospital of Xi'an, The First Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
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Le Bozec M, Tebeka S, Dubertret C, Sleurs D, Mhanna E, Le Strat Y. The association of stroke with mental and physical disorders in US adults: A nationally representative study. J Psychiatr Res 2023; 168:45-51. [PMID: 37897836 DOI: 10.1016/j.jpsychires.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/05/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023]
Abstract
Stroke has been linked to various physical and mental disorders, with both stroke and its comorbidities significantly impacting public health. In this population-based study, we evaluate the relationships between stroke, physical conditions, mental disorders, and their effect on quality of life. Data were gathered from a nationally representative sample of 36,309 civilian participants aged 18 years and older in the National Epidemiologic Survey on Alcohol and Related Conditions-III. We examined the prevalence of past-year stroke, its sociodemographic characteristics, and its associations with past-year mental disorders (according to the DSM-5) and physical conditions. Furthermore, we explored the connections between stroke and health-related quality of life, accounting for comorbidities. The past 12-month stroke prevalence was estimated at 0.82%. Participants with stroke exhibited a significantly higher past 12-month mental disorder prevalence than those without stroke. Specifically, individuals with stroke faced a higher risk of mood disorders, anxiety disorders, tobacco use disorder, and opioid use disorder compared to those without stroke. Stroke was also positively associated with 24 out of the 27 physical conditions assessed in this study. Participants with stroke experienced lower mental and physical quality of life compared to those without stroke. Stroke was significantly related to numerous mental and physical disorders. The association of stroke with diminished health-related quality of life was not only mediated by these comorbidities but should also be considered as inherently linked to stroke itself.
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Affiliation(s)
- Manon Le Bozec
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France.
| | - Sarah Tebeka
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
| | - Caroline Dubertret
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
| | - David Sleurs
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
| | - Elsa Mhanna
- Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
| | - Yann Le Strat
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
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4
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Abstract
The medical disorders of alcoholism rank among the leading public health problems worldwide and the need for predictive and prognostic risk markers for assessing alcohol use disorders (AUD) has been widely acknowledged. Early-phase detection of problem drinking and associated tissue toxicity are important prerequisites for timely initiations of appropriate treatments and improving patient's committing to the objective of reducing drinking. Recent advances in clinical chemistry have provided novel approaches for a specific detection of heavy drinking through assays of unique ethanol metabolites, phosphatidylethanol (PEth) or ethyl glucuronide (EtG). Carbohydrate-deficient transferrin (CDT) measurements can be used to indicate severe alcohol problems. Hazardous drinking frequently manifests as heavy episodic drinking or in combinations with other unfavorable lifestyle factors, such as smoking, physical inactivity, poor diet or adiposity, which aggravate the metabolic consequences of alcohol intake in a supra-additive manner. Such interactions are also reflected in multiple disease outcomes and distinct abnormalities in biomarkers of liver function, inflammation and oxidative stress. Use of predictive biomarkers either alone or as part of specifically designed biological algorithms helps to predict both hepatic and extrahepatic morbidity in individuals with such risk factors. Novel approaches for assessing progression of fibrosis, a major determinant of prognosis in AUD, have also been made available. Predictive algorithms based on the combined use of biomarkers and clinical observations may prove to have a major impact on clinical decisions to detect AUD in early pre-symptomatic stages, stratify patients according to their substantially different disease risks and predict individual responses to treatment.
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Affiliation(s)
- Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, Seinäjoki, Finland.
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5
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Peng X, Tang X, Zhang JH, Chen Y. Smoking Bans and Circulatory System Disease Mortality Reduction in Macao (China): Using GRA Models. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4516. [PMID: 36901524 PMCID: PMC10001606 DOI: 10.3390/ijerph20054516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 05/13/2023]
Abstract
This study evaluates the association between smoking rates and mortality from circulatory system diseases (CSD) after implementing a series of smoking bans in Macao (China). (1) Background: Macao phased in strict total smoking bans since 2012. During the past decade, smoking rates among Macao women have dropped by half. CSD mortalities in Macao also show a declining trend. (2) Method: Grey relational analysis (GRA) models were adopted to rank the importance of some key factors, such as income per capita, physician density, and smoking rates. Additionally, regressions were performed with the bootstrapping method. (3) Results: Overall, smoking rate was ranked as the most important factor affecting CSD mortality among the Macao population. It consistently remains the primary factor among Macao's female population. Each year, on average 5 CSD-caused deaths were avoided among every 100,000 women, equivalent to about 11.45% of the mean annual CSD mortality. (4) Conclusions: After the implementation of smoking bans in Macao, the decrease in smoking rate among women plays a primary role in the reduction in CSD mortality. To avoid excess CSD mortality due to smoking, Macao needs to continue to promote smoking cessation among the male population.
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Affiliation(s)
- Xinxin Peng
- School of Business, Macao University of Science and Technology, Macao 999078, China
- School of Management, Jiangsu University of Technology, Changzhou 213001, China
| | - Xiaolei Tang
- School of Business, Macao University of Science and Technology, Macao 999078, China
| | - Jing Hua Zhang
- School of Business, Macao University of Science and Technology, Macao 999078, China
| | - Yijun Chen
- Faculty of Social Sciences, University of Macau, Macao 999078, China
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Chung JW, Lee SR, Choi EK, Park SH, Lee H, Choi J, Han M, Ahn HJ, Kwon S, Lee S, Han K, Kim S, Oh S, Lip GYH. Cumulative Alcohol Consumption Burden and the Risk of Stroke in Young Adults: A Nationwide Population-Based Study. Neurology 2023; 100:e505-e515. [PMID: 36323515 PMCID: PMC9931082 DOI: 10.1212/wnl.0000000000201473] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/12/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Alcohol consumption is one of the important modifiable risk factors for stroke in young adults. The association between the cumulative burden of alcohol consumption and its impact on incident stroke in young adults is unknown. We aimed to investigate the association between cumulative alcohol burden and the risk for stroke among young adults. METHODS Using data from the Korean National Health Insurance Service database, patients age between 20 and 39 years, who underwent 4 consecutive annual health examinations between 2009 and 2012, were included. The cumulative alcohol burden score of moderate-to-heavy drinking was evaluated by assigning a score of 1 for alcohol consumption ≥105 g/wk at the health examination each year and calculating the sum of 4 years (0-4). The main outcome was incident stroke and its subtypes, ischemic stroke, and hemorrhagic stroke during the follow-up period. RESULTS Of 1 536 668 patients (mean age of 29.5 years, 71.5% male, and median follow-up of 6-year), 3 153 experienced an incident stroke (incidence rate, 0.37 per 1,000 person-years). After multivariable adjustment, patients with alcohol burden scores of 2, 3, and 4, who consumed more than 105 g/wk of alcohol for 2, 3, and 4 years, demonstrated significantly higher risks for stroke (hazard ratio [HR] 1.19, 95% CI 1.05-1.34 for 2; HR 1.22, 95% CI 1.09-1.38 for 3; HR 1.23, 95% CI 1.10-1.38 for 4) compared with those with a burden score of 0. This positive dose-response relationship was primarily driven by hemorrhagic rather than ischemic stroke. High alcohol burden scores (i.e., 2, 3, and 4) were significantly associated with higher risks for hemorrhagic stroke (HR 1.30, 95% CI 1.10-1.54 for 2; HR 1.42, 95% CI 1.21-1.67 for 3; HR 1.36, 95% CI 1.16-1.59 for 4) compared with a burden score of 0. DISCUSSION Young adults who engaged in moderate-to-heavy drinking demonstrated a higher risk for incident stroke, especially hemorrhagic stroke. Reducing alcohol consumption should be emphasized in young adults with heavy drinking habits as part of any stroke prevention strategy.
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Affiliation(s)
- Jae-Wook Chung
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - So-Ryoung Lee
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Eue-Keun Choi
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark.
| | - Sang-Hyeon Park
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - HuiJin Lee
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - JungMin Choi
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark.
| | - Minju Han
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Hyo-Jeong Ahn
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Soonil Kwon
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - SeungWoo Lee
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Kyungdo Han
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Sunhwa Kim
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Seil Oh
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Gregory Y H Lip
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
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Smyth A, O'Donnell M, Rangarajan S, Hankey GJ, Oveisgharan S, Canavan M, McDermott C, Xavier D, Zhang H, Damasceno A, Avezum A, Pogosova N, Oguz A, Ryglewicz D, Iversen HK, Lanas F, Rosengren A, Yusuf S, Langhorne P. Alcohol Intake as a Risk Factor for Acute Stroke: The INTERSTROKE Study. Neurology 2023; 100:e142-e153. [PMID: 36220600 PMCID: PMC9841450 DOI: 10.1212/wnl.0000000000201388] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/26/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There is uncertainty about the association between alcohol consumption and stroke, particularly for low-moderate intake. We explored these associations in a large international study. METHODS INTERSTROKE, a case-control study, is the largest international study of risk factors for acute stroke. Alcohol consumption was self-reported and categorized by drinks/week as low (1-7), moderate (7-14 for females and 7-21 for males), or high (>14 for females and >21 for males). Heavy episodic drinking (HED) was defined as >5 drinks on ≥1 day per month. Multivariable conditional logistic regression was used to determine associations. RESULTS We included 12,913 cases and 12,935 controls; 25.0% (n = 6,449) were current drinkers, 16.7% (n = 4,318) former drinkers, and 58.3% (n = 15,076) never drinkers. Current drinkers were younger, male, smokers, active, and with higher-paid occupations. Current drinking was associated with all stroke (OR 1.14; 95% CI 1.04-1.26) and intracerebral hemorrhage (ICH) (OR 1.50, 95% CI 1.21-1.84) but not ischemic stroke (OR 1.06; 95% CI 0.95-1.19). HED pattern was associated with all stroke (OR 1.39; 95% CI 1.21-1.59), ischemic stroke (OR 1.29; 95% CI 1.10-1.51), and ICH (OR 1.76; 95% CI 1.31-2.36). High level of alcohol intake was consistently associated with all stroke, ischemic stroke, and ICH. Moderate intake was associated with all stroke and ICH but not ischemic stroke. Low alcohol intake was not associated with stroke overall, but there were regional differences; low intake was associated with reduced odds of stroke in Western Europe/North America (OR 0.66; 95% CI 0.45-0.96) and increased odds in India (OR 2.18; 95% CI 1.42-3.36) (p-interaction 0.037). Wine consumption was associated with reduced odds of all stroke and ischemic stroke but not ICH. The magnitudes of association were greatest in those without hypertension and current smokers. DISCUSSION High and moderate intake were associated with increased odds of stroke, whereas low intake was not associated with stroke. However, there were important regional variations, which may relate to differences in population characteristics of alcohol consumers, types or patterns of consumption.
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Affiliation(s)
- Andrew Smyth
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom.
| | - Martin O'Donnell
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Sumathy Rangarajan
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Graeme J Hankey
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Shahram Oveisgharan
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Michelle Canavan
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Clodagh McDermott
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Denis Xavier
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Hongye Zhang
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Albertino Damasceno
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Alvaro Avezum
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Nana Pogosova
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Aytekin Oguz
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Danuta Ryglewicz
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Helle Klingenberg Iversen
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Fernando Lanas
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Annika Rosengren
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Salim Yusuf
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
| | - Peter Langhorne
- From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom
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8
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Abdellatif SY, Fares NH, Elsharkawy SH, Mahmoud YI. Calanus oil attenuates isoproterenol-induced cardiac hypertrophy by regulating myocardial remodeling and oxidative stress. Ultrastruct Pathol 2023; 47:12-21. [PMID: 36588172 DOI: 10.1080/01913123.2022.2163016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Calanus oil, an oil extracted from the marine crustacean Calanus finmarchicus, is one of the richest sources of omega-3 and poly-unsaturated fatty acids. Although calanus oil has been shown to have a significant anti-hypertensive, anti-inflammatory, anti-fibrotic and anti-obesity effects in various cardiovascular diseases, but little is known about its effect on pathological cardiac hypertrophy. Thus, the present study was carried out to evaluate the therapeutic effect of calanus oil on cardiac hypertrophy. Cardiac hypertrophy was induced by subcutaneous injections with isoproterenol (5 mg/kg b.w) for 14 consecutive days. Calanus oil (400 mg/kg) was given orally for 4 weeks. Cardiac pathological remodeling was evaluated by echocardiography, after which morphometric, biochemical, histological and ultrastructural analyses were performed. Calanus oil treatment significantly ameliorated isoproterenol-induced structural and functional alterations in echocardiography. Calanus oil also reduced the relative heart weight, significantly decreased the elevated cardiac enzymes (LDH and CK-MB) and the lipid peroxidation marker (MDA), augmented the myocardial antioxidant status (TAC), and ameliorated the histopathological and ultrastructural changes in cardiac tissues and prevented interstitial collagen deposition. The present study, for the first time, provided morphometric, biochemical, histological and ultrastructural evidences supporting the promising anti-hypertrophic effect of calanus oil against ISO-induced cardiac hypertrophy. This anti-hypertrophic effect of calanus oil is via regulating myocardial remodeling and oxidative stress. Therefore, it could be used as potential pharmacological intervention in the management of cardiac hypertrophy.
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Affiliation(s)
| | - Nagui H Fares
- Zoology Department, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Samar H Elsharkawy
- Department of Surgery, Anaesthesiology and Radiology, Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt
| | - Yomna I Mahmoud
- Zoology Department, Faculty of Science, Ain Shams University, Cairo, Egypt
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9
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Niemelä O, Aalto M, Bloigu A, Bloigu R, Halkola AS, Laatikainen T. Alcohol Drinking Patterns and Laboratory Indices of Health: Does Type of Alcohol Preferred Make a Difference? Nutrients 2022; 14:4529. [PMID: 36364789 PMCID: PMC9658819 DOI: 10.3390/nu14214529] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 09/10/2023] Open
Abstract
Although excessive alcohol consumption is a highly prevalent public health problem the data on the associations between alcohol consumption and health outcomes in individuals preferring different types of alcoholic beverages has remained unclear. We examined the relationships between the amounts and patterns of drinking with the data on laboratory indices of liver function, lipid status and inflammation in a national population-based health survey (FINRISK). Data on health status, alcohol drinking, types of alcoholic beverages preferred, body weight, smoking, coffee consumption and physical activity were recorded from 22,432 subjects (10,626 men, 11,806 women), age range 25-74 years. The participants were divided to subgroups based on the amounts of regular alcohol intake (abstainers, moderate and heavy drinkers), patterns of drinking (binge or regular) and the type of alcoholic beverage preferred (wine, beer, cider or long drink, hard liquor or mixed). Regular drinking was found to be more typical in wine drinkers whereas the subjects preferring beer or hard liquor were more often binge-type drinkers and cigarette smokers. Alcohol use in all forms was associated with increased frequencies of abnormalities in the markers of liver function, lipid status and inflammation even at rather low levels of consumption. The highest rates of abnormalities occurred, however, in the subgroups of binge-type drinkers preferring beer or hard liquor. These results demonstrate that adverse consequences of alcohol occur even at moderate average drinking levels especially in individuals who engage in binge drinking and in those preferring beer or hard liquor. Further emphasis should be placed on such patterns of drinking in policies aimed at preventing alcohol-induced adverse health outcomes.
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Affiliation(s)
- Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, 60220 Seinäjoki, Finland
| | - Mauri Aalto
- Department of Psychiatry, Seinäjoki Central Hospital, Tampere University, 33100 Tampere, Finland
| | - Aini Bloigu
- Center for Life Course Health Research, University of Oulu, 90570 Oulu, Finland
| | - Risto Bloigu
- Infrastructure of Population Studies, Faculty of Medicine, University of Oulu, 90570 Oulu, Finland
| | - Anni S. Halkola
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, 60220 Seinäjoki, Finland
| | - Tiina Laatikainen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), 00271 Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70210 Kuopio, Finland
- Joint Municipal Authority for North Karelia Social and Health Services, 80210 Joensuu, Finland
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10
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Birditt KS, Turkelson A, Polenick CA, Cranford JA, Blow FC. Alcohol Use and Blood Pressure Among Older Couples: The Moderating Role of Negative Marital Quality. J Gerontol B Psychol Sci Soc Sci 2022; 77:1592-1602. [PMID: 35219278 PMCID: PMC9434470 DOI: 10.1093/geronb/gbac015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Spouses often have concordant drinking behaviors and important influences on one another's cardiovascular health. However, little is known about the implications of dyadic drinking patterns for blood pressure, and the marital factors that confer risk or resilience. This article examined links between alcohol use and blood pressure within individuals and opposite-sex couples over time, and whether those links vary by negative marital quality among older adults. METHODS Participants were from the nationally representative longitudinal Health and Retirement Study that included 4,619 respondents in 2,682 opposite-sex couples who participated in at least 2 of the waves from 2006 to 2016. Participants reported the number of drinks they typically consume per week, negative marital quality, and had their blood pressure measured via a cuff. RESULTS Analyses revealed that greater drinking was associated with increased systolic blood pressure among both husbands and wives. Furthermore, husbands who drank more had higher blood pressure when wives drank more alcohol, whereas there was no association between husbands' drinking and blood pressure when wives drank less alcohol. Interactions with negative marital quality showed that drinking concordance may be associated with increased blood pressure over time in more negative marriages. DISCUSSION Findings indicated that spousal drinking concordance, although often associated with positive marital quality, may have negative long-term health effects.
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Affiliation(s)
- Kira S Birditt
- Address correspondence to: Kira S. Birditt, PhD, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA. E-mail:
| | - Angela Turkelson
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | | | - James A Cranford
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Frederic C Blow
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
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11
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Brust JC. Stroke and Substance Abuse. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00039-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Fogelman N, Hwang S, Sinha R, Seo D. Social Support Effects on Neural Stress and Alcohol Reward Responses. Curr Top Behav Neurosci 2021; 54:461-482. [PMID: 34734391 DOI: 10.1007/7854_2021_246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Social support (SS), or having people to depend on during times of stress, may offer an emotional and neurological buffer to problem drinking. Specifically, SS may modulate reward and stress-related brain responses to mitigate perceptions of alcohol reward and stress. There is limited evidence, however, on this topic and specifically on brain networks that may modulate SS effects on stress and alcohol reward. Here we present a review of the current literature on this topic as well as data from a large community sample of 115 social drinkers. Findings from a novel fMRI task viewing alcohol cue, stress, and neutral images, in separate blocks, while providing ratings on subjective feelings of alcohol craving, stress, and arousal are included. Lower SS significantly predicted greater alcohol craving during alcohol cue and stress conditions, higher baseline levels of stress, and greater arousal in the alcohol cue, relative to neutral condition. Remarkably, individuals with low SS showed greater reward activation (ventral medial prefrontal cortex (VmPFC) and ventral striatum) during alcohol cue exposure, while those with high SS showed no such activation (p < 0.001, family wise error corrected at 0.05). Furthermore, individuals with lower SS showed greater stress circuit (VmPFC, dorsal striatum, and periaqueductal gray) activation not observed in the high SS groups. Both groups showed increased amygdala activation under stress condition. The findings support the notion that SS is a powerful modulator of stress response and reward motivation. High SS buffers neural and subjective stress responses, while low SS potentiates greater reward seeking with higher alcohol craving and greater brain activation during alcohol cue exposure. Previous research and current results suggest the need to further explore the role of SS in those at risk of developing alcohol use disorder and assess novel prevention strategies to boost SS in at-risk drinkers.
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Affiliation(s)
- Nia Fogelman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Seungju Hwang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Dongju Seo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
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13
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Predicting the risk of stroke in patients with late-onset epilepsy: A machine learning approach. Epilepsy Behav 2021; 122:108211. [PMID: 34325155 DOI: 10.1016/j.yebeh.2021.108211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The goal of this cohort study was to estimate the predictors for ischemic stroke in patients with epilepsy in a large database containing data from general practitioners in Germany using machine learning methods. METHODS This retrospective cohort study included 11,466 patients aged ≥ 60 years with an initial diagnosis of epilepsy in 1182 general practices in Germany between January 2010 and December 2018 from the IQVIA Disease Analyzer database. The Sub-Population Optimization and Modeling Solutions (SOMS) tool was used to identify subgroups at a higher risk of stroke than the overall population with epilepsy based on 37 different variables. RESULTS A total of seven variables were considered important. Four co-diagnoses (diabetes, hypertension, heart failure, and alcohol dependence) were by far the strongest predictors with a combined predictive ability of more than 90%, whereby diabetes (41.4%) was the strongest predictor, followed by hypertension (35.0%) and heart failure (11.8%). The predictive importance of male gender was only 1.5%, and age was not recognized as an important predictor. Finally, the prescribed AEDs levetiracetam, with a predictive importance of 5.0%, and valproate, with 2.7%, were found to be weak predictors. CONCLUSION The stroke risk in patients with epilepsy was relatively high and could be predicted based on comorbidities such as diabetes mellitus, hypertension, heart failure, and alcohol dependence. Knowing and addressing these factors may help reduce the risk of stroke in patients with epilepsy.
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14
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Sempionatto JR, Lin M, Yin L, De la Paz E, Pei K, Sonsa-Ard T, de Loyola Silva AN, Khorshed AA, Zhang F, Tostado N, Xu S, Wang J. An epidermal patch for the simultaneous monitoring of haemodynamic and metabolic biomarkers. Nat Biomed Eng 2021; 5:737-748. [PMID: 33589782 DOI: 10.1038/s41551-021-00685-1] [Citation(s) in RCA: 210] [Impact Index Per Article: 70.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/12/2021] [Indexed: 02/02/2023]
Abstract
Monitoring the effects of daily activities on the physiological responses of the body calls for wearable devices that can simultaneously track metabolic and haemodynamic parameters. Here we describe a non-invasive skin-worn device for the simultaneous monitoring of blood pressure and heart rate via ultrasonic transducers and of multiple biomarkers via electrochemical sensors. We optimized the integrated device so that it provides mechanical resiliency and flexibility while conforming to curved skin surfaces, and to ensure reliable sensing of glucose in interstitial fluid and of lactate, caffeine and alcohol in sweat, without crosstalk between the individual sensors. In human volunteers, the device captured physiological effects of food intake and exercise, in particular the production of glucose after food digestion, the consumption of glucose via glycolysis, and increases in blood pressure and heart rate compensating for oxygen depletion and lactate generation. Continuous and simultaneous acoustic and electrochemical sensing via integrated wearable devices should enrich the understanding of the body's response to daily activities, and could facilitate the early prediction of abnormal physiological changes.
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Affiliation(s)
- Juliane R Sempionatto
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, USA
| | - Muyang Lin
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, USA
| | - Lu Yin
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, USA
| | - Ernesto De la Paz
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, USA
| | - Kexin Pei
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, USA
| | - Thitaporn Sonsa-Ard
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, USA
| | | | - Ahmed A Khorshed
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, USA
| | - Fangyu Zhang
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, USA
| | - Nicholas Tostado
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, USA
| | - Sheng Xu
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, USA.
| | - Joseph Wang
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, USA.
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15
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Cheng H, Gu X, He Z, Yang Y. Dose-response relationship between working hours and hypertension: A 22-year follow-up study. Medicine (Baltimore) 2021; 100:e25629. [PMID: 33879739 PMCID: PMC8078318 DOI: 10.1097/md.0000000000025629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/31/2021] [Indexed: 01/04/2023] Open
Abstract
Hypertension causes a substantial burden to society. Some studies found that hypertension was associated with the working type and working hours. The purpose of the current study is to assess the dose-response relationship between working hours and hypertension.Data of 12,080 adults aged 18 to 65 years who attended the China Health and Nutrition Survey (CHNS) between 1989 and 2011 were analyzed. Hypertension was determined based on systolic and/or diastolic blood pressure measures, or having doctor-diagnosed hypertension. Multivariable Cox regression and restricted cubic spline to assess the dose-response relationship between working hours and hypertension.A total of 12,080 participants including 5852 females and 6228 males. By the last follow-up (2011), a total of 830 participants were hypertensive, with an incidence of 6.9%. After adjusting socio-demographic, lifestyle factors, as well as occupation type, compared with those who worked 35 to 49 hours per week, participants who worked no more than 34 hours per week (HR: 1.21, 95%CI: 1.03-1.41) and at least 56 hours per week (HR: 1.38, 95%CI: 1.19-1.59) had a higher risk of hypertension. The significant association between long working hours (at least 56 hours per week) and hypertension was observed among females (HR: 1.38, 95%CI: 1.16-1.64) and males (HR: 1.36, 95%CI: 1.04-1.78). Among manual workers, the relationship between long working hours and hypertension was observed (HR: 1.49, 95%CI: 1.10-2.02). The relationship between long working hours (HR: 1.21, 95%CI: 1.01-1.44) and short working hours (HR: 1.37, 95%CI: 1.16-1.61) and hypertension was observed among nonmanual workers. The hazard ratio of hypertension and working time displayed U-shape non-linear relationship (Ptrend < .001, non-linear P < .001). The non-linear response-dose relationship was found in manual worker, nonmanual worker, and male (Ptrend < .001, non-linear P < .001).The association between working time and hypertension showed U-shape relationship. Specifically, overtime work was an important occupational risk factors for adults, and short work time was related to hazard ratio of hypertension in nonmanual workers.
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Affiliation(s)
- Hao Cheng
- Shaanxi Cancer Hospital Affiliated to Xi’an Jiaotong University, Department of Ultrasonography, Xi’an 710061
| | - Xuan Gu
- Xi’an Hospital of Civil Aviation, Xi’an 710082
| | - Zhenan He
- Shaanxi Institute of Medical Device Quality Supervision and Inspection, Xi’an 712046
| | - Yanqiu Yang
- Department of Ultasonography, The Fifth People's Hospital of Qinghai Province, China
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16
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Greenlund IM, Cunningham HA, Tikkanen AL, Bigalke JA, Smoot CA, Durocher JJ, Carter JR. Morning sympathetic activity after evening binge alcohol consumption. Am J Physiol Heart Circ Physiol 2021; 320:H305-H315. [PMID: 33185112 PMCID: PMC7864252 DOI: 10.1152/ajpheart.00743.2020] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 01/14/2023]
Abstract
Binge alcohol consumption elicits acute and robust increases of muscle sympathetic nerve activity (MSNA), yet the impact of evening binge drinking on morning-after MSNA is unknown. The present study examined the effects of evening binge alcohol consumption on polysomnographic sleep and morning-after MSNA. We hypothesized that evening binge drinking (i.e. 4-5 drink equivalent in <2 h) would reduce sleep quality and increase morning-after blood pressure (BP) and MSNA. Following a familiarization night within the sleep laboratory, 22 participants (12 men, 10 women; 25 ± 1 yr) were examined after simulated binge drinking or fluid control (randomized, crossover design). Morning MSNA was successfully recorded across both conditions in 16 participants (8 men, 8 women) during a 10-min baseline and three Valsalva's maneuvers (VM). Binge drinking reduced rapid eye movement (REM) sleep (15 ± 1 vs. 20 ± 1%, P = 0.003), increased stage II sleep (54 ± 1 vs. 51 ± 1%, P = 0.002), and increased total urine output (2.9 ± 0.2 vs. 2.1 ± 0.1 liters, P < 0.001) but did not alter morning-after urine specific gravity. Binge drinking increased morning-after heart rate [65 (54-72) vs. 58 (51-67) beats/min, P = 0.013] but not resting BP or MSNA. Binge drinking elicited greater sympathoexcitation during VM (38 ± 3 vs. 43 ± 3 bursts/min, P = 0.036). Binge drinking augmented heart rate (P = 0.002), systolic BP (P = 0.022), and diastolic BP (P = 0.037) reactivity to VM phase IV and blunted cardiovagal baroreflex sensitivity during VM phases II (P = 0.028) and IV (P = 0.043). In conclusion, evening binge alcohol consumption disrupted REM sleep and morning-after autonomic function. These findings provide new mechanistic insight into the potential role of binge drinking on cardiovascular risk.NEW & NOTEWORTHY Chronic binge alcohol consumption is associated with future cardiovascular disease (CVD) risk in both men and women. In addition, binge alcohol consumption is known to disrupt normal sleep quality during the early morning hours, coinciding with the morning sympathetic surge. In the present study, an evening of binge alcohol consumption increased baseline morning heart rate and cardiovascular reactivity during the Valsalva maneuver (VM) strain. Specifically, muscle sympathetic nerve activity and phase IV hemodynamic responses increased during VM the morning after binge alcohol consumption. The autonomic dysfunction and increased cardiovascular reactivity during VM suggests a contributing mechanism to CVD risk present in individuals who binge drink.
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Affiliation(s)
- Ian M Greenlund
- Department of Psychology, Montana State University, Bozeman, Montana
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Hannah A Cunningham
- Department of Health and Human Development, Montana State University, Bozeman, Montana
| | - Anne L Tikkanen
- Department of Health and Human Development, Montana State University, Bozeman, Montana
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Jeremy A Bigalke
- Department of Psychology, Montana State University, Bozeman, Montana
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Carl A Smoot
- Department of Health and Human Development, Montana State University, Bozeman, Montana
| | - John J Durocher
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
- Department of Biological Sciences, Purdue University Northwest, Hammond, Indiana
| | - Jason R Carter
- Department of Health and Human Development, Montana State University, Bozeman, Montana
- Department of Psychology, Montana State University, Bozeman, Montana
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
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17
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Association between the incidence of hypertension and alcohol consumption pattern and the alcohol flushing response: A 12-year follow-up study. Alcohol 2020; 89:43-48. [PMID: 32702501 DOI: 10.1016/j.alcohol.2020.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/24/2020] [Accepted: 07/13/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Alcohol consumption is associated with hypertension, and this association depends on the alcohol consumption pattern and alcohol flushing response. In this 12-year follow-up study, we investigated the relationship between the alcohol consumption pattern and incidence of hypertension in the Korean population. METHODS We analyzed 1,366 Korean participants in the Ansung-Ansan cohort study without hypertension at baseline. The subjects were classified into four alcohol consumption patterns: never-drinking, light alcohol consumption, moderate alcohol consumption, and heavy alcohol consumption, and as flushers or non-flushers in response to alcohol. RESULTS In flushers, moderate and heavy alcohol consumption patterns increased the risk of incident hypertension compared with never-drinkers [moderate: HR 1.811 (95% CI 1.084-3.028); heavy: HR 2.494 (95% CI 1.185-5.247)], but non-flushers were not associated with increased risk of incident hypertension according to the alcohol consumption pattern. In addition, a heavy alcohol consumption pattern increased the risk of hypertension among flushers compared with non-flushers [HR 2.232 (95% CI 1.054-4.728)]. CONCLUSION In this 12-year follow-up study, we observed that moderate and heavy alcohol consumption was associated with an increased risk of hypertension in flushers. Especially, a heavy alcohol consumption pattern in flushers markedly increased the risk of hypertension.
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18
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Ng Fat L, Bell S, Britton A. A life-time of hazardous drinking and harm to health among older adults: findings from the Whitehall II prospective cohort study. Addiction 2020; 115:1855-1866. [PMID: 32233123 PMCID: PMC7487058 DOI: 10.1111/add.15013] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 07/19/2019] [Accepted: 02/12/2020] [Indexed: 01/20/2023]
Abstract
AIMS To investigate associations of life-time hazardous and binge drinking with biomarkers of cardiometabolic health, liver function, cardiovascular disease (CVD) and mortality. DESIGN Prospective cohort study with median follow-up time to CVD incidence of 4.5 years. SETTING London, UK: civil servants within the Whitehall II Study. PARTICIPANTS A total of 4820 drinkers aged 59-83 years with biological measurements during the 2011-12 survey. MEASUREMENTS Hazardous drinking was defined as having an AUDIT-C score ≥ 5 calculated at each decade of life, forming the following groups: never hazardous drinker, former early (stopping before age 50), former later (stopping after age 50), current hazardous drinker and consistent hazardous drinker (hazardous drinker at each decade of life). FINDINGS More than half the sample had been hazardous drinkers at some point during their life-time, comprising former early (< age 50) (19%), former later (≥ age 50) (11%), current (21%) and consistent hazardous drinker (AUDIT-C ≥ 5 across life (5%). After adjusting for covariates, waist circumference was larger with more persistent hazardous drinking (e.g. compared with never hazardous drinkers, former early had increased waist circumference by 1.17 cm [95% confidence interval (CI) = 0.25-2.08]; former later by 1.88 cm (CI = 0.77-2.98); current by 2.44 cm (CI = 1.50-3.34) and consistent hazardous drinker by 3.85 cm (CI = 2.23-5.47). Current hazardous drinkers had higher systolic blood pressure (2.44 mmHg, CI = 1.19-3.68) and fatty liver index scores (4.05 mmHg, CI = 2.92-5.18) than never hazardous drinkers. Current hazardous drinkers [hazard ratio (HR) = 2.75, CI = 1.44-5.22) had an elevated risk of stroke, and former later hazardous drinkers had an elevated risk of non-CVD mortality (HR = 1.93, CI = 1.19-3.14) than never hazardous drinkers. Life-time binge drinking was associated with larger waist circumferences and poorer liver function compared with never binge drinkers. CONCLUSION Hazardous drinking may increase cardiometabolic risk factors; this is made worse by persistent hazardous drinking throughout life, particularly in relation to weight gain, suggesting benefits of early intervention.
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Affiliation(s)
- Linda Ng Fat
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - Steven Bell
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary CareUniversity of Cambridge, Strangeways Research LaboratoryCambridgeUK,National Institute for Health Research Blood and Transplant Unit in Donor Health and Genomics at the University of Cambridge, Strangeways Research LaboratoryCambridgeUK,Stroke Research Group, Department of Clinical NeurosciencesCambridge Biomedical CampusCambridgeUK
| | - Annie Britton
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
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Osborne B, Kelly PJ, Larance B, Robinson LD, Ivers R, Deane FP, Webber A, Kelly D. Substance Use and Co-occurring Physical Health Problems: File Review of a Residential Drug and Alcohol Treatment Service. J Dual Diagn 2020; 16:250-259. [PMID: 31877110 DOI: 10.1080/15504263.2019.1704960] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objectives: Physical health conditions cause significant disability and mortality among people living with alcohol and other drug problems. There has been limited research on the prevalence of health problems among clinical samples of people with substance use disorders, particularly among those in residential treatment. Yet residential settings provide unique opportunity for responding to health needs. To better understand the health of people attending treatment for substance use disorders, this study conducted a file review to examine the prevalence of physical health problems as identified during routine residential care. Methods: A retrospective review of client files collected between 2013 and 2017 (N = 172) was completed at a residential treatment service in NSW, Australia. Data were extracted to examine the prevalence of physical health problems recorded at entry into treatment. Correlates of health problems were estimated using bivariate descriptive analyses and logistic regression. Results: The majority of clients in treatment for substance use had a comorbid physical health problem (80.7%). Musculoskeletal problems were the most frequently reported medical issue (38.6%). Odds for some physical health problems were related to client gender, age, and primary substance of concern. Male gender remained the strongest predictor of dental health problems when controlling for age and substance type (odds ratio [OR] = 3.60). Primary alcohol use remained the strongest predictor of nutritional deficiencies when controlling for client age (OR = 4.43). Among clients with a physical health problem and who had a treatment episode of at least 14 days (n = 110), just over half (55.5%) were referred to a health-related practitioner or service during their treatment episode. Conclusions: This study contributes to the literature by reporting on the incidence of physical health problems among people in residential treatment for substance use disorders. The high prevalence of physical health morbidity iterates the role of non-medical staff working within drug and alcohol services in the identification of client health needs. The findings support calls for systematic screening of physical health as part of routine care for substance use disorders improved integration of substance treatment and the broader primary health care system.
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Affiliation(s)
- Briony Osborne
- Illawarra Health and Medical Research Institute, Wollongong, Australia.,School of Psychology, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute, Wollongong, Australia.,School of Psychology, University of Wollongong, Wollongong, Australia
| | - Briony Larance
- Illawarra Health and Medical Research Institute, Wollongong, Australia.,School of Psychology, University of Wollongong, Wollongong, Australia
| | - Laura D Robinson
- Illawarra Health and Medical Research Institute, Wollongong, Australia.,School of Psychology, University of Wollongong, Wollongong, Australia
| | - Rowena Ivers
- School of Public Health, University of Sydney, Sydney, Australia.,Graduate School of Medicine, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- Illawarra Health and Medical Research Institute, Wollongong, Australia.,School of Psychology, University of Wollongong, Wollongong, Australia
| | - Adrian Webber
- St Vincent de Paul Services, Lewisham, New South Wales, Australia
| | - David Kelly
- St Vincent de Paul Services, Lewisham, New South Wales, Australia
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20
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Peng J, Wang H, Rong X, He L, Xiangpen L, Shen Q, Peng Y. Cerebral Hemorrhage and Alcohol Exposure: A Review. Alcohol Alcohol 2019; 55:20-27. [PMID: 31845978 DOI: 10.1093/alcalc/agz087] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 08/29/2019] [Accepted: 09/17/2019] [Indexed: 01/20/2023] Open
Abstract
Abstract
Aims
To investigate the dose–response relationships between alcohol and intracerebral hemorrhage (ICH), the impact of alcohol on the outcome of ICH and possible mechanisms underlying hypertensive ICH (HICH) caused by heavy drinking.
Methods
Literature search from 1985 to August 2019 in the PubMed database.
Results
The relationship between low-middle alcohol consumption and ICH remains controversial for various reasons, whereas chronic heavy drinking increases the incidence of ICH and exerts worse outcome. More attention is needed to clarify the characteristics of chronic alcohol intake and binge drinking. Chronic alcohol abuse tends to elevates blood pressure, resulting in increased occurrence of HICH and exaggerated HICH-contributed brain injury.
Conclusion
It is important to develop strategies to promote reasonable intake categories, prevent alcoholism and thus reduce the risk of ICH.
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Affiliation(s)
- Jialing Peng
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. No. 33 Yinfeng Road, Guangzhou 510828
| | - Hongxuan Wang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. No. 33 Yinfeng Road, Guangzhou 510828
| | - Xiaoming Rong
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. No. 33 Yinfeng Road, Guangzhou 510828
| | - Lei He
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. No. 33 Yinfeng Road, Guangzhou 510828
| | - L Xiangpen
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. No. 33 Yinfeng Road, Guangzhou 510828
| | - Qingy Shen
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. No. 33 Yinfeng Road, Guangzhou 510828
| | - Ying Peng
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. No. 33 Yinfeng Road, Guangzhou 510828
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. No. 33 Yinfeng Road, Guangzhou 510828
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21
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Nichols LJ, Gall S, Stirling C. Determining rural risk for aneurysmal subarachnoid hemorrhages: A structural equation modeling approach. J Neurosci Rural Pract 2019; 7:559-565. [PMID: 27695237 PMCID: PMC5006469 DOI: 10.4103/0976-3147.188627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
An aneurysmal subarachnoid hemorrhage (aSAH) carries a high disability burden. The true impact of rurality as a predictor of outcome severity is unknown. Our aim is to clarify the relationship between the proposed explanations of regional and rural health disparities linked to severity of outcome following an aSAH. An initial literature search identified limited data directly linking geographical location, rurality, rural vulnerability, and aSAH. A further search noting parallels with ischemic stroke and acute myocardial infarct literature presented a number of diverse and interrelated predictors. This a priori knowledge informed the development of a conceptual framework that proposes the relationship between rurality and severity of outcome following an aSAH utilizing structural equation modeling. The presented conceptual framework explores a number of system, environmental, and modifiable risk factors. Socioeconomic characteristics, modifiable risk factors, and timely treatment that were identified as predictors of severity of outcome following an aSAH and within each of these defined predictors a number of contributing specific individual predictors are proposed. There are considerable gaps in the current knowledge pertaining to the impact of rurality on the severity of outcome following an aSAH. Absent from the literature is any investigation of the cumulative impact and multiplicity of risk factors associated with rurality. The proposed conceptual framework hypothesizes a number of relationships between both individual level and system level predictors, acknowledging that intervening predictors may mediate the effect of one variable on another.
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Affiliation(s)
- Linda Jayne Nichols
- School of Health Sciences, Faculty of Health Science, University of Tasmania, Hobart Tasmania, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart Tasmania, Australia
| | - Christine Stirling
- Menzies Institute for Medical Research, University of Tasmania, Hobart Tasmania, Australia
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22
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Alcohol Binge-Induced Cardiovascular Dysfunction Involves Endocannabinoid-CB1-R Signaling. JACC Basic Transl Sci 2019; 4:625-637. [PMID: 31768478 PMCID: PMC6872859 DOI: 10.1016/j.jacbts.2019.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/04/2019] [Accepted: 05/13/2019] [Indexed: 01/21/2023]
Abstract
Alcohol is one of the most frequently used intoxicants in the United States. Binge alcohol drinking is a major contributor of emergency department visits. Binge alcohol drinking may adversely affect cardiovascular function. Here we show that acute alcohol intoxication is associated with elevated levels of cardiac endocannabinoid anandamide and profound cardiovascular dysfunction and blood redistribution lasting for several hours. The adverse cardiovascular effects of acute alcohol intoxication are attenuated by CB1-R antagonist or in CB1-R knockout mice. A single alcohol binge has profound effect on the cardiovascular system, which involves endocannabinoid-CB1-R signaling.
Excessive binge alcohol drinking may adversely affect cardiovascular function. In this study we characterize the detailed hemodynamic effects of an acute alcohol binge in mice using multiple approaches and investigate the role of the endocannabinoid–cannabinoid 1 receptor (CB1-R) signaling in these effects. Acute alcohol binge was associated with elevated levels of cardiac endocannabinoid anandamide and profound cardiovascular dysfunction lasting for several hours and redistribution of circulation. These changes were attenuated by CB1-R antagonist or in CB1-R knockout mice. Our results suggest that a single alcohol binge has profound effects on the cardiovascular system, which involve endocannabinoid–CB1-R signaling.
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Key Words
- 2-AG, 2-arachidonyl glycerol
- AEA, anandamide
- CB1-R (CB1), cannabinoid 1 receptor
- CB2-R (CB2), cannabinoid 2 receptor
- EF, ejection fraction
- LV, left ventricle
- MAP, mean arterial pressure
- P-V, pressure-volume
- PRSW, preload recruitable stroke work
- TPR, total peripheral resistance
- binge alcohol drinking
- cannabinoids
- contractility
- dP/dtmax, maximal slope of pressure increment
- endocannabinoids
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23
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Liver enzymes in alcohol consumers with or without binge drinking. Alcohol 2019; 78:13-19. [PMID: 30890357 DOI: 10.1016/j.alcohol.2019.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/28/2019] [Accepted: 03/04/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND While alcohol use is linked with a wide variety of health problems, the question of whether differences in drinking patterns could yield different outcomes has remained unclear. PATIENTS AND METHODS We measured liver enzymes (ALT, GGT) from alcohol consumers with or without binge drinking from a population-based sample in Finland, where binge-type drinking is common. Data on alcohol use, diet, body weight, lifestyle (smoking, coffee consumption, physical activity), and health status were collected from 19225 subjects (9492 men, 9733 women), aged 25-74 years. The participants were subsequently classified to subgroups, both according to the frequencies of binge drinking and the amounts of regular alcohol intake (low-, medium-, and high-risk drinking). RESULTS The quantity of regular alcohol use was roughly linearly related with GGT and ALT activities. ANOVA analyses of the trends according to the frequency of binge drinking showed a significant GGT increase in both men (p < 0.0005) and women (p < 0.0005), and a significant increase of ALT in men (p < 0.0005). In those with low-risk overall consumption, markedly higher GGT (p < 0.0005) and ALT (p < 0.0005) occurred in those with binge drinking more than once a month, compared with those with no such occasions. Binge drinking occurring ≤1/month also resulted in higher GGT (p < 0.0005) and ALT (p < 0.05) activities. CONCLUSIONS These results emphasize possible adverse consequences of binge drinking on hepatic function even in those with low-risk overall consumption. The pattern of drinking should be more systematically implicated in clinical recommendations for drinking reduction.
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24
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Sanchez A, Chung SC, Mejia A, Ramirez FE, Shavlik GW, Bivens RL, Brown-Fraser S, Gallant RD. Multiple lifestyle interventions reverses hypertension. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1636534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Albert Sanchez
- NEWSTART Program, Weimar Institute, Weimar, CA, USA
- Department of Public Health Nutrition and Wellness, Andrews University, Berrien Springs, MI, USA
| | - S. Christine Chung
- Department of Public Health Nutrition and Wellness, Andrews University, Berrien Springs, MI, USA
| | - Alfredo Mejia
- Department of Public Health Nutrition and Wellness, Andrews University, Berrien Springs, MI, USA
| | - Francisco E. Ramirez
- NEWSTART Program, Weimar Institute, Weimar, CA, USA
- Research, Nedley Clinic, Weimar, CA, USA
| | | | | | - Sherine Brown-Fraser
- Department of Public Health Nutrition and Wellness, Andrews University, Berrien Springs, MI, USA
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25
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Chang SL, Huang W, Han H, Sariyer IK. Binge-Like Exposure to Ethanol Enhances Morphine's Anti-nociception in B6 Mice. Front Psychiatry 2019; 9:756. [PMID: 30723430 PMCID: PMC6349749 DOI: 10.3389/fpsyt.2018.00756] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 12/20/2018] [Indexed: 01/01/2023] Open
Abstract
Elevation of the blood ethanol concentration (BEC) to > 80 mg/dL (17.4 mM) after binge drinking enhances inflammation in brain and neuroimmune signaling pathways. Morphine abuse is frequently linked to excessive drinking. Morphine exerts its actions mainly via the seven transmembrane G-protein-coupled mu opioid receptors (MORs). Opioid use disorders (OUDs) include combination of opioids with alcohol, leading to opioid overdose-related deaths. We hypothesized that binge drinking potentiates onset and progression of OUD. Using C57BL/6J (B6) mice, we first characterized time-dependent inflammatory gene expression change as molecular markers using qRT-PCR within 24 h after binge-like exposure to high-dose, high-concentration ethanol (EtOH). The mice were given one injection of EtOH (5 g/kg, 42% v/v, i.g.) and sacrificed at 2.5 h, 5 h, 7.5 h, or 24 h later. Inflammatory cytokines interleukin (IL)-1β, IL-6, and IL-18 were elevated in both the striatum (STr) and the nucleus accumbens (NAc) of the mice. We then investigated the expression profile of MOR in the STr at 2 min, 5 h, or 24 h after the first EtOH injection and at 24 h and 48 h after the third injection. This binge-like exposure to EtOH upregulated MOR expression in the STr and NAc, an effect that could enhance morphine's anti-nociception. Therefore, we examined the impact of binge-like exposure to EtOH on morphine's anti-nociception at the behavioral level. The mice were treated with or without 3-d binge-like exposure to EtOH, and the anti-nociceptive changes were evaluated using the hot-plate test 24 h after the final (3rd) EtOH injection with or without a cumulative subcutaneous dose (0, 0.1, 0.3, 1.0, and 3.0 mg/kg) of morphine at intervals of 30 min. The response curve of the mice given EtOH was shifted to the left, showing enhanced latency to response to morphine up to 3 mg/kg. Furthermore, co-treatment with the MOR antagonist naltrexone blocked morphine's anti-nociception in animals given either EtOH or saline. This confirms that MOR is involved in binge-like exposure to EtOH-induced changes in morphine's anti-nociception. Our results suggest that EtOH enhanced latency to analgesic response to morphine, and such effect might initiate the onset and progression of OUDs.
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Affiliation(s)
- Sulie L Chang
- Institute of NeuroImmune Pharmacology, South Orange, NJ, United States
- Department of Biological Sciences, Seton Hall University, South Orange, NJ, United States
| | - Wenfei Huang
- Institute of NeuroImmune Pharmacology, South Orange, NJ, United States
- Department of Biological Sciences, Seton Hall University, South Orange, NJ, United States
| | - Haijun Han
- Institute of NeuroImmune Pharmacology, South Orange, NJ, United States
| | - Ilker K Sariyer
- Department of Neuroscience, Temple University School of Medicine, Philadelphia, PA, United States
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26
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Polenick CA, Birditt KS, Blow FC. Couples' Alcohol Use in Middle and Later Life: Stability and Mutual Influence. J Stud Alcohol Drugs 2018; 79:111-118. [PMID: 29227239 PMCID: PMC5894855 DOI: 10.15288/jsad.2018.79.111] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Wives and husbands may influence one another's alcohol use, but little is known about within-couple patterns of alcohol consumption over time during midlife and later life. Drawing from a nationally representative U.S. sample of middle-aged and older married couples, we examined individual stability and partner influence in alcohol use across a 16-year period. METHOD The analytic sample comprised 1,257 married couples age 40 and older who completed nine waves of the Health and Retirement Study (1996-2012). Dyadic multilevel models were estimated to simultaneously examine the stability of one's own alcohol use (number of drinks per occasion and per week) over time as well as whether partner drinking predicted subsequent alcohol use within couples. Models controlled for marital duration. RESULTS Wives' and husbands' own prior alcohol use positively predicted alcohol use across waves, demonstrating individual stability in drinking patterns. Partners' alcohol use also positively predicted wives' and husbands' subsequent alcohol use, revealing partner influence in drinking patterns. Both stability and influence effects were stronger for husbands than for wives. CONCLUSIONS This study provides evidence of stability and mutual influence in long-term patterns of alcohol use within mid- and late-life married couples. Findings highlight the interdependence between spouses and indicate that partners' drinking should be considered when examining men's and women's alcohol use over time.
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Affiliation(s)
- Courtney A. Polenick
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Correspondence may be sent to: Courtney A. Polenick at the Department of Psychiatry, University of Michigan, 2800 Plymouth Rd, Building 16, Room 200S, Ann Arbor, MI 48109, or via email at:
| | - Kira S. Birditt
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Frederic C. Blow
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Veterans Affairs Ann Arbor Healthcare System, Center for Clinical Management Research, Ann Arbor, Michigan
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27
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Kisioglu B, Nergiz-Unal R. The powerful story against cardiovascular diseases: Dietary factors. FOOD REVIEWS INTERNATIONAL 2017. [DOI: 10.1080/87559129.2017.1410172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Betul Kisioglu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Reyhan Nergiz-Unal
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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28
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Fiala J, Sochor O, Klimusová H, Homolka M. Alcohol Consumption in Population Aged 25-65 Years Living in the Metropolis of South Moravia, Czech Republic. Cent Eur J Public Health 2017; 25:191-199. [PMID: 29022677 DOI: 10.21101/cejph.a4481] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 12/02/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate alcohol consumption in a representative sample of the population of the city of Brno, as part of research on cardiovascular risk factors. METHODS Cross-sectional survey on a sample of 2,160 randomly selected residents 35-65 years old was carried out. For the invited volunteers who became a part of the investigation, alcohol consumption was determined in a controlled, face to face interview structured in accordance with a special questionnaire form. The frequency of alcohol consumption during the previous year was determined, in more detail during the last month (including quantification using "units of alcohol", their normal and maximum level of drinking, and any association between alcohol consumption and meals), and during the last week in the form of a complete, beverage specified and quantified 7-day recall period. Typical patterns of alcohol consumption were explored by the means of cluster analysis. RESULTS During the past 12 months, 90.0% of the men and 79.0% of the women had consumed alcohol, the rest can be considered abstinent. The most commonly reported frequency was 2-4 times per week (35.6% of the men), or 1-3 times per month (22.8% of the women). Daily or almost daily consumption was reported by 24.8% of the men and 12.8% of the women. The number of units of alcohol consumed usually on one occasion amounts to an average of 3.88±4.80 for the men and 2.25±1.39 for the women, but the amount most often cited by both sexes was 2 drinks (36.4% of the men and 40.4% of the women). The largest amount consumed on any occasion during the last 30 days was 5 or more units in 69.3% of the men, and in 33.9% of the women it was 4 or more units (this amount of alcohol leads to a blood alcohol concentration (BAC) of 0.08, the border of drunkenness). In 19.9% of the men and 7.5% of the women, this border was exceeded more than 5 times in the past month. Only 14.7% of the men and 10.3% of the women reported that the majority of their alcohol consumption occurs with food; on the contrary, 64.3% of the men and 77.6% of the women drinkers drink it either always without food or only rarely with it. During the past week, 81.6% of the men and 63.4% of the women drank alcohol (p<0.001, chi-square). The average value of consumption for one man was 11.57±11.91 doses, and for one woman 4.68±6.38 doses per week (p<0.001, t-test). A total of 17.8% of the men exceeded the limit of 21 doses per week, and 7.4% of the women exceeded 14 doses/week. After converting the weekly consumption into the number of units of alcohol per week expressed in litres per year, the total average consumption was 5.01±6.36 litres; for the men 7.26±7.62 litres and for the women 3.02±4.08 litres of pure alcohol per person annually. Consumption during the week was not uniform (p<0.001, ANOVA), with the highest occurring on Saturday, followed by Friday. The men mostly drank beer (62.9% of the total volume of alcohol), the women wine (68.6%). The cluster analysis identified 5 clusters of respondents, based on a set of alcohol consumption variables, as follows: very heavy drinking (1.6% of the respondents who drink alcohol); heavy drinking (8.8%); binge drinking (6.3%); moderate drinking (31.1%); and occasional drinking (52.3%). CONCLUSIONS The results show a relatively high consumption of alcohol in the examined group. The recommended weekly limits were exceeded by only a small portion, but that consumption had a binge character. Conversion into a form allowing comparison with conventional national statistics shows a significantly lower consumption than these reported statements. Overall, men consume significantly more alcohol than women.
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Affiliation(s)
- Jindřich Fiala
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,International Clinical Research Centre, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Ondřej Sochor
- International Clinical Research Centre, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Helena Klimusová
- Institute of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic
| | - Martin Homolka
- International Clinical Research Centre, St. Anne's University Hospital Brno, Brno, Czech Republic
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29
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Body weight-dependent relationships between alcohol consumption and pulse pressure in middle-aged Japanese women. ACTA ACUST UNITED AC 2017; 11:801-810.e2. [PMID: 29102320 DOI: 10.1016/j.jash.2017.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/22/2017] [Accepted: 09/24/2017] [Indexed: 11/23/2022]
Abstract
High pulse pressure is a risk factor for cardiovascular disease, and excessive alcohol drinking increases the risk of hypertension. The purpose of this study was to elucidate the relationship between alcohol intake and pulse pressure in women and to determine whether body weight influences their relationship. The subjects were 18,791 Japanese middle-aged women, and they were divided into tertile groups for body weight or three different body mass index (BMI, kg/m2) groups (low BMI <22; middle BMI ≥22 and <25; high BMI ≥25). The subjects in each group were further divided into four groups of nondrinkers, occasional drinkers, regular light drinkers, and regular heavy drinkers by habitual alcohol consumption. Pulse pressure levels were compared between nondrinkers and drinkers in each group for body weight or BMI. Pulse pressure was significantly higher in regular heavy drinkers than in nondrinkers in the first tertile group for body weight and in the low BMI group but not in the second and third tertile groups for body weight and in the middle and high BMI groups. In all tertile groups and all BMI groups, pulse pressure was not significantly different in occasional drinkers and regular light drinkers than in nondrinkers. In women with lower body weight, heavy drinking was positively associated with pulse pressure, while this association was not found in women with middle or higher body weight. Thus, body weight potently confounds the relationship between alcohol consumption and pulse pressure.
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30
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Boehme AK, Esenwa C, Elkind MSV. Stroke Risk Factors, Genetics, and Prevention. Circ Res 2017; 120:472-495. [PMID: 28154098 PMCID: PMC5321635 DOI: 10.1161/circresaha.116.308398] [Citation(s) in RCA: 781] [Impact Index Per Article: 111.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/05/2017] [Accepted: 01/05/2017] [Indexed: 12/18/2022]
Abstract
Stroke is a heterogeneous syndrome, and determining risk factors and treatment depends on the specific pathogenesis of stroke. Risk factors for stroke can be categorized as modifiable and nonmodifiable. Age, sex, and race/ethnicity are nonmodifiable risk factors for both ischemic and hemorrhagic stroke, while hypertension, smoking, diet, and physical inactivity are among some of the more commonly reported modifiable risk factors. More recently described risk factors and triggers of stroke include inflammatory disorders, infection, pollution, and cardiac atrial disorders independent of atrial fibrillation. Single-gene disorders may cause rare, hereditary disorders for which stroke is a primary manifestation. Recent research also suggests that common and rare genetic polymorphisms can influence risk of more common causes of stroke, due to both other risk factors and specific stroke mechanisms, such as atrial fibrillation. Genetic factors, particularly those with environmental interactions, may be more modifiable than previously recognized. Stroke prevention has generally focused on modifiable risk factors. Lifestyle and behavioral modification, such as dietary changes or smoking cessation, not only reduces stroke risk, but also reduces the risk of other cardiovascular diseases. Other prevention strategies include identifying and treating medical conditions, such as hypertension and diabetes, that increase stroke risk. Recent research into risk factors and genetics of stroke has not only identified those at risk for stroke but also identified ways to target at-risk populations for stroke prevention.
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Affiliation(s)
- Amelia K Boehme
- From the Department of Epidemiology, Mailman School of Public Health (A.K.B., M.S.V.E.) and Department of Neurology, College of Physicians and Surgeons (A.K.B., C.E., M.S.V.E.), Columbia University, New York, NY
| | - Charles Esenwa
- From the Department of Epidemiology, Mailman School of Public Health (A.K.B., M.S.V.E.) and Department of Neurology, College of Physicians and Surgeons (A.K.B., C.E., M.S.V.E.), Columbia University, New York, NY
| | - Mitchell S V Elkind
- From the Department of Epidemiology, Mailman School of Public Health (A.K.B., M.S.V.E.) and Department of Neurology, College of Physicians and Surgeons (A.K.B., C.E., M.S.V.E.), Columbia University, New York, NY.
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31
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Yao X, Zhang K, Bian J, Chen G. Alcohol consumption and risk of subarachnoid hemorrhage: A meta-analysis of 14 observational studies. Biomed Rep 2016; 5:428-436. [PMID: 27699009 PMCID: PMC5038345 DOI: 10.3892/br.2016.743] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 08/03/2016] [Indexed: 12/30/2022] Open
Abstract
The association between alcohol consumption and the risk of subarachnoid hemorrhage (SAH) is inconsistent. Thus, meta- and a dose-response analyses are presented with the purpose of assessing their associations. A systematic literature search was performed using Pubmed and Embase electronic databases for pertinent observational studies. Random-effects or fixed-effect models were employed to combine the estimates of the relative risks (RRs) with corresponding 95% confidence intervals (CIs). A dose-response pattern was conducted for further analysis. The current meta-analysis includes 14 observational studies reporting data on 483,553 individuals and 2,556 patients. The combined RRs of light alcohol consumption (<15 g/day) and moderate alcohol consumption (15–30 g/day) compared with teetotal individuals were 1.27 (95% CI: 0.95, 1.68) and 1.33 (95% CI: 0.84, 2.09), respectively, which indicated no significant association between light-to-moderate alcohol consumption and SAH. An increased risk of SAH was noted in heavy alcohol consumption (>30 g/day) when compared with no alcohol consumption, as demonstrated by a result of 1.78 (95% CI: 1.46, 2.17). Dose-response analysis showed evidence of a linear association (P=0.0125) between alcohol consumption and SAH. The risk of SAH increased by 12.1% when alcohol consumption was increased by 10 g/day. Therefore, heavy alcohol consumption was found to be associated with an increased risk of SAH. Furthermore, the association between SAH and alcohol consumption has clinical relevance with regard to risk factor modification and the primary and secondary prevention of SAH.
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Affiliation(s)
- Xiyang Yao
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Kai Zhang
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Jieyong Bian
- Department of Neurosurgery, Suzhou Xiangcheng People's Hospital, Suzhou, Jiangsu 215131, P.R. China
| | - Gang Chen
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
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Rehm J, Shield KD, Roerecke M, Gmel G. Modelling the impact of alcohol consumption on cardiovascular disease mortality for comparative risk assessments: an overview. BMC Public Health 2016; 16:363. [PMID: 27121289 PMCID: PMC4848866 DOI: 10.1186/s12889-016-3026-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 04/19/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Although alcohol consumption has long been considered as a risk factor for chronic disease, the relationship to cardiovascular disease (CVD) is complex and involves at least two dimensions: average volume of alcohol consumption and patterns of drinking. The objective of this contribution was to estimate the burden of CVD mortality caused by alcohol consumption. METHODS Risk assessment modelling with alcohol-attributable CVD mortality as primary outcome. The mortality burden of ischaemic heart disease (IHD) and ischaemic stroke (IS) attributable to alcohol consumption was estimated using attributable-fraction methodology. Relative Risk (RR) data for IHD and IS were obtained from the most comprehensive meta-analyses (except for Russia and surrounding countries where alcohol RR data were obtained from a large cohort study). Age-group specific RRs were calculated, based on large studies. Data on mortality were obtained from the World Health Organization's Global Health Estimates and alcohol consumption data were obtained from the Global Information System on Alcohol and Health. Risk of former drinkers was modelled taking into account global differences in the prevalence of sick quitters among former drinkers. Alcohol-attributable mortality estimates for all other CVD causes except IHD and IS were obtained from the 2014 Global Status Report on Alcohol and Health. RESULTS An estimated 780,381 CVD deaths (441,893 and 338,490 CVD deaths among men and women respectively) were attributable to alcohol consumption globally in 2012, accounting for 1.4 % of all deaths and 26.6 % of all alcohol-attributable deaths. This is in contrast to the previously estimated 1,128,273 CVD deaths attributable to alcohol consumption globally, and represents a decrease of 30.8 % in alcohol-attributable CVD mortality and of 10.6 % in the global burden of all alcohol-attributable deaths. CONCLUSIONS When the most comprehensive and recent systematic reviews and meta-analyses are taken as bases, the net impact of alcohol consumption on CVD is lower than previously estimated.
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Affiliation(s)
- Jürgen Rehm
- Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1, ON, Canada. .,Addiction Policy, Dalla Lana School of Public Health, University of Toronto (UofT), 155 College Street, 6th FL, Toronto, M5T 3 M7, ON, Canada. .,Department of Psychiatry, Faculty of Medicine, UofT, 250 College Street, 8th FL, Toronto, M5T 1R8, ON, Canada. .,Faculty of Medicine, Institute of Medical Science, UofT, Medical Sciences Bldg, 1 King's College Circle, Room 2374, Toronto, M5S 1A8, ON, Canada. .,Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, Dresden, 01187, Germany.
| | - Kevin D Shield
- Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1, ON, Canada.,Faculty of Medicine, Institute of Medical Science, UofT, Medical Sciences Bldg, 1 King's College Circle, Room 2374, Toronto, M5S 1A8, ON, Canada
| | - Michael Roerecke
- Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1, ON, Canada
| | - Gerrit Gmel
- Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1, ON, Canada.,School of Electrical Engineering and Telecommunications, The University of New South Wales, High Street, Kensington, NSW 2052, Australia.,Implant Systems Group, National Information and Communications Technology Australia, Sydney, Australia 13 Garden Street, Eveleigh, NSW 2015, Australia
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Rostamian S, van Buchem MA, Westendorp RGJ, Jukema JW, Mooijaart SP, Sabayan B, de Craen AJM. Executive function, but not memory, associates with incident coronary heart disease and stroke. Neurology 2015; 85:783-9. [PMID: 26245926 DOI: 10.1212/wnl.0000000000001895] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/04/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the association of performance in cognitive domains executive function and memory with incident coronary heart disease and stroke in older participants without dementia. METHODS We included 3,926 participants (mean age 75 years, 44% male) at risk for cardiovascular diseases from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) with Mini-Mental State Examination score ≥24 points. Scores on the Stroop Color-Word Test (selective attention) and the Letter Digit Substitution Test (processing speed) were converted to Z scores and averaged into a composite executive function score. Likewise, scores of the Picture Learning Test (immediate and delayed memory) were transformed into a composite memory score. Associations of executive function and memory were longitudinally assessed with risk of coronary heart disease and stroke using multivariable Cox regression models. RESULTS During 3.2 years of follow-up, incidence rates of coronary heart disease and stroke were 30.5 and 12.4 per 1,000 person-years, respectively. In multivariable models, participants in the lowest third of executive function, as compared to participants in the highest third, had 1.85-fold (95% confidence interval [CI] 1.39-2.45) higher risk of coronary heart disease and 1.51-fold (95% CI 0.99-2.30) higher risk of stroke. Participants in the lowest third of memory had no increased risk of coronary heart disease (hazard ratio 0.99, 95% CI 0.74-1.32) or stroke (hazard ratio 0.87, 95% CI 0.57-1.32). CONCLUSION Lower executive function, but not memory, is associated with higher risk of coronary heart disease and stroke. Lower executive function, as an independent risk indicator, might better reflect brain vascular pathologies.
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Affiliation(s)
- Somayeh Rostamian
- From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark
| | - Mark A van Buchem
- From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark
| | - Rudi G J Westendorp
- From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark
| | - J Wouter Jukema
- From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark
| | - Simon P Mooijaart
- From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark
| | - Behnam Sabayan
- From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark.
| | - Anton J M de Craen
- From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark
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Lee EK, Kim OS, Hong JY. Characteristics and Factors Associated with Problem Drinking in Male Workers. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9:132-7. [PMID: 26160242 DOI: 10.1016/j.anr.2015.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 11/20/2014] [Accepted: 02/02/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aimed to identify the characteristics and factors related to problem drinking in male workers. METHODS This study was conducted using a cross-sectional survey and 232 male workers, who completed self-reported questionnaires addressing alcohol consumption, drinking motives, job stress, supervisor/coworker support, and family support. Multivariate analysis was used to uncover factors associated with problem drinking. RESULTS As compared with normal alcohol users, problem drinkers were more likely to smoke and had greater family support and coping motivations, and fewer confirmatory motives. Problem drinking was found to be related to perceived health status (adjusted odds ratio [OR] = 0.78, 95% confidence interval [CI] [0.64, 0.95]), current smoking (adjusted OR = 2.79, 95% CI [1.26, 6.18]), family support (adjusted OR = 2.04, 95% CI [1.23, 3.39]), confirmatory motivation (adjusted OR = 0.60, 95% CI [0.37, 0.96]), and coping (adjusted OR = 1.79, 95% CI [1.04, 3.07]). CONCLUSIONS Our findings suggest that any interventions targeting problem drinking among male workers must address smoking cessation, control of stress, and the improvement of drinking subculture in the workplace.
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Affiliation(s)
- Eun Kyung Lee
- College of Nursing, Catholic University of Daegu, Daegu, South Korea.
| | - Ok Soo Kim
- Division of Nursing Science, Ewha Womans University, Seoul, South Korea
| | - Ji Yeon Hong
- Department of Nursing Science, Howon University, Gunsan, South Korea
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Abebe SM, Berhane Y, Worku A, Getachew A. Prevalence and associated factors of hypertension: a crossectional community based study in northwest ethiopia. PLoS One 2015; 10:e0125210. [PMID: 25909382 PMCID: PMC4409323 DOI: 10.1371/journal.pone.0125210] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 03/23/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hypertension, being the root cause of many of the body sytem and organs failure, remains to be a major public health challenge globally. Though the problem is huge in both developed and developing countries, data are scarce in developing countries like Ethiopia. Therefore, this study was aimed to determine the magnitude and associated factors of hypertension in North West Ethiopia. METHODS A cross-sectional survey was conducted on adults aged 35 years and above in the rural and urban communities of Dabat district and Gondar town in 2012. The data were collected using the WHO STEPwise strategy. Hypertension was defined as having a Systolic blood pressure of ≥140 mmHg and/ or a Diastolic BP of ≥ 90mmHg or a reported use of anti-hypertensive medications for raised blood pressure. Prevalence was computed with a 95% confidence interval. Selected risk factors were assessed using a biviarete logistic regression. RESULTS A total of 2200 participants were included in the study. The median age (±SD) was 47 (±12.4) years. The overall prevalence of hypertension was found to be 27.9% [95% CI 26.0, 29.8], with the proportion in the urban and rural residents being 30.7% and 25.3% respectively. The prevalence of hypertension was 29.3% for women and 26.3% for men. Out of the 598 hypertensive patients 241 (40.3%) had blood pressure measurements, and 99 (16.6%) had known hypertension and were on treatment. The proportion of systolic and diastolic hypertension in this subgroup of adults was 133(6.2%). The multivariable logistic regression analysis showed older age (AOR = 1.06; 1.05, 1.07), raised fasting glucose (AOR = 1.01; 1.001, 1.01), alcohol consumption (AOR = 1.71; 1.24, 2.36), and raised BMI (AOR =1.07; 1.04, 1.10) were significantly associated with hypertension. CONCLUSION The prevalence of hypertension was considerably higher in rural areas than previously reported. The health system needs to develop strategies to increase the reach of relevant screening and diagnostic services to both rural and urban populations.
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Affiliation(s)
- Solomon Mekonnen Abebe
- Institute of Public health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Assefa Getachew
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Moussa MN, Simpson SL, Mayhugh RE, Grata ME, Burdette JH, Porrino LJ, Laurienti PJ. Long-term moderate alcohol consumption does not exacerbate age-related cognitive decline in healthy, community-dwelling older adults. Front Aging Neurosci 2015; 6:341. [PMID: 25601835 PMCID: PMC4283638 DOI: 10.3389/fnagi.2014.00341] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 12/06/2014] [Indexed: 11/13/2022] Open
Abstract
Recent census data has found that roughly 40% of adults 65 years and older not only consume alcohol but also drink more of it than previous generations. Older drinkers are more vulnerable than younger counterparts to the psychoactive effects of alcohol due to natural biological changes that occur with aging. This study was specifically designed to measure the effect of long-term moderate alcohol consumption on cognitive health in older adult drinkers. An extensive battery of validated tests commonly used in aging and substance use literature was used to measure performance in specific cognitive domains, including working memory and attention. An age (young, old) (*) alcohol consumption (light, moderate) factorial study design was used to evaluate the main effects of age and alcohol consumption on cognitive performance. The focus of the study was then limited to light and moderate older drinkers, and whether or not long-term moderate alcohol consumption exacerbated age-related cognitive decline. No evidence was found to support the idea that long-term moderate alcohol consumption in older adults exacerbates age-related cognitive decline. Findings were specific to healthy community dwelling social drinkers in older age and they should not be generalized to individuals with other consumption patterns, like heavy drinkers, binge drinkers or ex-drinkers.
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Affiliation(s)
- Malaak N. Moussa
- Laboratory for Complex Brain Networks, Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
- Neuroscience Program, Wake Forest School of MedicineWinston-Salem, NC, USA
| | - Sean L. Simpson
- Laboratory for Complex Brain Networks, Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
- Department of Biostatistical Sciences, Wake Forest School of MedicineWinston-Salem, NC, USA
| | - Rhiannon E. Mayhugh
- Laboratory for Complex Brain Networks, Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
- Neuroscience Program, Wake Forest School of MedicineWinston-Salem, NC, USA
| | | | - Jonathan H. Burdette
- Laboratory for Complex Brain Networks, Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
- Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
| | - Linda J. Porrino
- Department of Physiology and Pharmacology, Wake Forest School of MedicineWinston-Salem, NC, USA
| | - Paul J. Laurienti
- Laboratory for Complex Brain Networks, Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
- Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
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Meschia JF, Bushnell C, Boden-Albala B, Braun LT, Bravata DM, Chaturvedi S, Creager MA, Eckel RH, Elkind MSV, Fornage M, Goldstein LB, Greenberg SM, Horvath SE, Iadecola C, Jauch EC, Moore WS, Wilson JA. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45:3754-832. [PMID: 25355838 PMCID: PMC5020564 DOI: 10.1161/str.0000000000000046] [Citation(s) in RCA: 986] [Impact Index Per Article: 98.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this updated statement is to provide comprehensive and timely evidence-based recommendations on the prevention of stroke among individuals who have not previously experienced a stroke or transient ischemic attack. Evidence-based recommendations are included for the control of risk factors, interventional approaches to atherosclerotic disease of the cervicocephalic circulation, and antithrombotic treatments for preventing thrombotic and thromboembolic stroke. Further recommendations are provided for genetic and pharmacogenetic testing and for the prevention of stroke in a variety of other specific circumstances, including sickle cell disease and patent foramen ovale.
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Roerecke M, Rehm J. Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers. BMC Med 2014; 12:182. [PMID: 25567363 PMCID: PMC4203905 DOI: 10.1186/s12916-014-0182-6] [Citation(s) in RCA: 217] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 09/10/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Alcohol consumption is a major global risk factor for mortality and morbidity. Much discussion has revolved around the diverse findings on the complex relationship between alcohol consumption and the leading cause of death and disability, ischemic heart disease (IHD). METHODS We conducted a systematic search of the literature up to August 2014 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify meta-analyses and observational studies examining the relationship between alcohol drinking, drinking patterns, and IHD risk, in comparison to lifetime abstainers. In a narrative review we have summarized the many meta-analyses published in the last 10 years, discussing the role of confounding and experimental evidence. We also conducted meta-analyses examining episodic heavy drinking among on average moderate drinkers. RESULTS The narrative review showed that the use of current abstainers as the reference group leads to systematic bias. With regard to average alcohol consumption in relation to lifetime abstainers, the relationship is clearly J-shaped, supported by short-term experimental evidence and similar associations within strata of potential confounders, except among smokers. Women experience slightly stronger beneficial associations and also a quicker upturn to a detrimental effect at lower levels of average alcohol consumption compared to men. There was no evidence that chronic or episodic heavy drinking confers a beneficial effect on IHD risk. People with alcohol use disorder have an elevated risk of IHD (1.5- to 2-fold). Results from our quantitative meta-analysis showed that drinkers with average intake of <30 g/day and no episodic heavy drinking had the lowest IHD risk (relative risk = 0.64, 95% confidence interval 0.53 to 0.71). Drinkers with episodic heavy drinking occasions had a risk similar to lifetime abstainers (relative risk = 1.12, 95% confidence interval 0.91 to 1.37). CONCLUSIONS Epidemiological evidence for a beneficial effect of low alcohol consumption without heavy drinking episodes is strong, corroborated by experimental evidence. However, episodic and chronic heavy drinking do not provide any beneficial effect on IHD. Thus, average alcohol consumption is not sufficient to describe the risk relation between alcohol consumption and IHD. Alcohol policy should try to reduce heavy drinking patterns.
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Affiliation(s)
- Michael Roerecke
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada.
| | - Jürgen Rehm
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada.
- Dalla Lana School of Public Health (DLSPH), University of Toronto, Toronto, Canada.
- Institute of Medical Science, University of Toronto, Toronto, Canada.
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany.
- Department of Psychiatry, University of Toronto, Toronto, Canada.
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Abstract
Acute alcohol (ethanol) toxicity is a definition that encompasses both the metabolic toxicity of alcohol and the association of alcohol with traumatic deaths, suicide, and criminal activities. As with any postmortem measurement, there must be control of postmortem sampling, storage of specimens, and appropriate analysis to ensure that there is not artifactual alcohol production or incorrect measurement of other postmortem alcohols. It is almost unheard of for acute alcohol toxicity to cause death secondary to metabolic effects in a naïve individual, although there has been a recent trend in social media dares that have led to deaths due to isolated episodes of extreme alcohol consumption. However, in most cases, there will be evidence for chronic alcohol misuse at the postmortem examination.
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Affiliation(s)
- Stephen R. Morley
- Leicster Royal Infirmary, UK and Kings college London, UK, and the University of the West Indies
| | - Paul Smith
- Leicster Royal Infirmary - Toxicology Section, Leicster, UK
| | - Christopher Johnson
- University of Leicester - East Midlands Forensic Pathology Unit, Leicester, UK
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Abstract
Alcohol abuse and dependence are serious public health problems worldwide, resulting in significant morbidity, mortality, and legal implications. Therefore, sudden unexpected, suspicious, or violent death in alcohol consuming persons are frequently seen in the forensic setting. Alcohol-induced brain damage is predominantly caused by nutritional deficiencies and repeated withdrawal syndrome. Brain lesions associated with heavy alcohol consumption include brain atrophy, hepatic encephalopathy, and central pontine myelinolysis. In addition, the dementing conditions Wernicke-Korsakoff syndrome, acquired hepatocerebral degeneration, Marchiafava-Bignami disease, and pellagrous encephalopathy are closely associated with chronic alcohol consumption. In neuroradiological and autopsy studies, cerebral and cerebellar atrophy has been demonstrated in alcoholics. There is a regional selectivity, with the frontal lobes being particularly affected. Moreover, a disproportionate loss of cerebral white matter relative to cerebral cortex suggests that a major neurotoxic effect of chronic alcohol consumption predominantly affects the white matter.
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Affiliation(s)
- Andreas Büttner
- Forensic Pathology and the Institute of Legal Medicine at the Medical University of Rostock, Germany
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An Expanding Knowledge of the Mechanisms and Effects of Alcohol Consumption on Cardiovascular Disease. J Cardiopulm Rehabil Prev 2014; 34:159-71. [DOI: 10.1097/hcr.0000000000000042] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Rostamian S, Mahinrad S, Stijnen T, Sabayan B, de Craen AJM. Cognitive impairment and risk of stroke: a systematic review and meta-analysis of prospective cohort studies. Stroke 2014; 45:1342-8. [PMID: 24676778 DOI: 10.1161/strokeaha.114.004658] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND PURPOSE Cognitive impairment is linked to vascular risk factors and brain vascular pathologies. Several studies have tested whether subjects with cognitive impairment have higher risk for stroke. The aim of this study was to systematically review available evidence on the association between cognitive impairment and risk of stroke to obtain precise effect estimates of the association and to identify which cognitive domains associate most with incident stroke. METHODS PubMed, EMBASE, and Web of Science were searched from January 1, 1980, to October 1, 2013, without language restriction. Only prospective cohort studies were included. From each study, data on the association between cognitive impairment and stroke estimated with hazard ratios or relative risks with 95% confidence interval (CI) were extracted. For each study, risk of stroke per SD lower performance in various cognitive tests was calculated. RESULTS Twelve studies were included, comprising 82,899 participants of whom 3043 had an incident stroke. The pooled relative risk per SD lower global cognitive performance was 1.19 (95% CI, 1.12-1.27). Each SD lower score in executive function or attention was associated with 1.14-fold (95% CI, 1.06-1.24) higher risk of stroke. Lower scores in memory were associated with 1.07-fold (95% CI, 1.02-1.12) higher risk of stroke, and lower scores in language were associated with 1.08-fold (95% CI, 1.02-1.16) higher risk of stroke. CONCLUSIONS Cognitive impairment is associated with higher risk of stroke. The associations were not significantly different for executive function, memory, and language.
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Affiliation(s)
- Somayeh Rostamian
- From the Departments of Gerontology and Geriatrics (S.R., S.M., B.S., A.J.M.d.C.), Radiology (S.R., B.S.), and Medical Statistics and Bioinformatics (T.S.), Leiden University Medical Centre, Leiden, the Netherlands; and Netherlands Consortium for Healthy Ageing, Leiden, the Netherlands (A.J.M.d.C.)
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Tseng WS. Halitosis: Could it be a predictor of stroke? Med Hypotheses 2014; 82:335-7. [DOI: 10.1016/j.mehy.2013.12.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 12/27/2013] [Indexed: 12/21/2022]
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Yates PA, Villemagne VL, Ellis KA, Desmond PM, Masters CL, Rowe CC. Cerebral microbleeds: a review of clinical, genetic, and neuroimaging associations. Front Neurol 2014; 4:205. [PMID: 24432010 PMCID: PMC3881231 DOI: 10.3389/fneur.2013.00205] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 12/06/2013] [Indexed: 12/14/2022] Open
Abstract
Cerebral microbleeds (microbleeds) are small, punctuate hypointense lesions seen in T2* Gradient-Recall Echo (GRE) and Susceptibility-Weighted (SWI) Magnetic Resonance Imaging (MRI) sequences, corresponding to areas of hemosiderin breakdown products from prior microscopic hemorrhages. They occur in the setting of impaired small vessel integrity, commonly due to either hypertensive vasculopathy or cerebral amyloid angiopathy. Microbleeds are more prevalent in individuals with Alzheimer’s disease (AD) dementia and in those with both ischemic and hemorrhagic stroke. However they are also found in asymptomatic individuals, with increasing prevalence with age, particularly in carriers of the Apolipoprotein (APOE) ε4 allele. Other neuroimaging findings that have been linked with microbleeds include lacunar infarcts and white matter hyperintensities on MRI, and increased cerebral β-amyloid burden using 11C-PiB Positron Emission Tomography. The presence of microbleeds has been suggested to confer increased risk of incident intracerebral hemorrhage – particularly in the setting of anticoagulation – and of complications of immunotherapy for AD. Prospective data regarding the natural history and sequelae of microbleeds are currently limited, however there is a growing evidence base that will serve to inform clinical decision-making in the future.
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Affiliation(s)
- Paul A Yates
- Department of Nuclear Medicine and Centre for PET, Austin Health , Heidelberg, VIC , Australia ; Department of Medicine, The University of Melbourne , Parkville, VIC , Australia
| | - Victor L Villemagne
- Department of Nuclear Medicine and Centre for PET, Austin Health , Heidelberg, VIC , Australia ; Department of Medicine, The University of Melbourne , Parkville, VIC , Australia ; Florey Institute of Neuroscience and Mental Health, University of Melbourne , Parkville, VIC , Australia
| | - Kathryn A Ellis
- Department of Medicine, The University of Melbourne , Parkville, VIC , Australia ; Florey Institute of Neuroscience and Mental Health, University of Melbourne , Parkville, VIC , Australia
| | - Patricia M Desmond
- Department of Medicine, The University of Melbourne , Parkville, VIC , Australia ; Department of Radiology, Royal Melbourne Hospital , Parkville, VIC , Australia
| | - Colin L Masters
- Department of Medicine, The University of Melbourne , Parkville, VIC , Australia ; Florey Institute of Neuroscience and Mental Health, University of Melbourne , Parkville, VIC , Australia
| | - Christopher C Rowe
- Department of Nuclear Medicine and Centre for PET, Austin Health , Heidelberg, VIC , Australia ; Department of Medicine, The University of Melbourne , Parkville, VIC , Australia
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Schulte MT, Hser YI. Substance Use and Associated Health Conditions throughout the Lifespan. Public Health Rev 2014; 35:https://web-beta.archive.org/web/20150206061220/http://www.publichealthreviews.eu/upload/pdf_files/14/00_Schulte_Hser.pdf. [PMID: 28366975 PMCID: PMC5373082 DOI: 10.1007/bf03391702] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
A life stage perspective is necessary for development of age-appropriate strategies to address substance use disorders (SUDs) and related health conditions in order to produce better overall health and well-being. The current review evaluated the literature across three major life stages: adolescence, adulthood, and older adulthood. FINDINGS 1) Substance use is often initiated in adolescence, but it is during adulthood that prevalence rates for SUDs peak; and while substance involvement is less common among older adults, the risk for health complications associated with use increases. 2) Alcohol, tobacco, marijuana, and, increasingly, prescription medications, are the most commonly misused substances across age groups; however, the use pattern of these and other drugs and the salient impact vary depending on life stage. 3) In terms of health outcomes, all ages are at risk for overdose, accidental injury, and attempted suicide. Adolescents are more likely to be in vehicular accidents while older adults are at greater risk for damaging falls. Adulthood has the highest rates of associated medical conditions (e.g., cancer, sexually transmitted disease, heart disease) and mental health conditions (e.g., bipolar disorder, anxiety disorders, antisocial personality disorder). CONCLUSION Prolonged heavy use of drugs and/or alcohol results in an array of serious health conditions. Addressing SUDs from a life stage perspective with assessment and treatment approaches incorporating co-occurring disorders are necessary to successfully impact overall health.
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Affiliation(s)
- Marya T. Schulte
- UCLA Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA
| | - Yih-Ing Hser
- UCLA Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA
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Wakabayashi I. Associations between heavy alcohol drinking and lipid-related indices in middle-aged men. Alcohol 2013; 47:637-42. [PMID: 24239151 DOI: 10.1016/j.alcohol.2013.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 10/01/2013] [Accepted: 10/02/2013] [Indexed: 12/14/2022]
Abstract
The ratio of triglycerides to HDL cholesterol (TG/HDL-C ratio) and lipid accumulation product (LAP: a continuous marker of lipid over-accumulation determined by waist circumference and triglycerides) have been proposed to be good predictors of cardiovascular disease. The aim of this study was to clarify the relationships between heavy alcohol drinking and lipid-related indices including TG/HDL-C ratio, LAP, and ratio of LDL cholesterol to HDL cholesterol (LDL-C/HDL-C ratio). The subjects were middle-aged male nondrinkers and heavy drinkers (ethanol intake: ≥66 g per drinking day, which is 2-3 times or more than the generally recommended border level of daily alcohol consumption of 20-30 g). The levels of each lipid-related index after adjustment for age, smoking, and regular exercise were compared among nondrinkers, occasional heavy drinkers, and regular heavy drinkers. Log-transformed TG/HDL-C ratio was significantly higher in occasional heavy drinkers (mean ± standard error: 0.445 ± 0.014) than in nondrinkers (0.388 ± 0.004) and regular heavy drinkers (0.359 ± 0.013), and was not significantly different in nondrinkers and regular heavy drinkers. Log-transformed LAP was significantly higher in occasional heavy drinkers (1.51 ± 0.02) and regular heavy drinkers (1.44 ± 0.02) than in nondrinkers (1.34 ± 0.01), and was significantly higher in occasional heavy drinkers than in regular heavy drinkers. LDL-C/HDL-C ratio was significantly lower in occasional heavy drinkers (2.41 ± 0.04) and regular heavy drinkers (1.72 ± 0.04) than in nondrinkers (2.62 ± 0.01) and was significantly lower in regular heavy drinkers than in occasional heavy drinkers. Results of logistic regression analysis, using odds ratios for high lipid indices of occasional or regular heavy drinkers vs. nondrinkers, agreed with the above results of analysis of covariance. Occasional heavy drinkers showed more detrimental and less favorable levels of the lipid indices than did regular heavy drinkers, and thus heavy drinking, even if occasional, should be avoided to prevent cardiovascular disease.
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Droste DW, Iliescu C, Vaillant M, Gantenbein M, De Bremaeker N, Lieunard C, Velez T, Meyer M, Guth T, Kuemmerle A, Chioti A. A daily glass of red wine and lifestyle changes do not affect arterial blood pressure and heart rate in patients with carotid arteriosclerosis after 4 and 20 weeks. Cerebrovasc Dis Extra 2013; 3:121-9. [PMID: 24403903 PMCID: PMC3884179 DOI: 10.1159/000354847] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Regular consumption of small amounts of red wine improves blood lipids. However, there is concern whether this beneficial effect might be counterbalanced by an increase in blood pressure (BP) and heart rate (HR), which are risk factors for cerebro-cardiovascular disease. In particular, we studied whether regular consumption of red wine with and without lifestyle changes (LC; healthy diet and physical activity advice) results in an increase in BP and HR. METHODS A prospective, unblinded randomized trial was performed in 108 patients (67% men) with carotid atherosclerosis documented by ultrasound, a mean BP of 122/79 mm Hg and a mean HR of 71 bpm at inclusion in the study. Sixty-eight percent were known and treated hypertensives. The mean 24-hour BP at baseline was 122/79 mm Hg. Half of the study participants, the control group, was seen by a nurse at baseline, after 4 and after 20 weeks, and was instructed not to change their eating and physical activity habits. In the other half, a dietician performed five sessions of 30 min each (at baseline, after 1 week and after 2, 3 and 4 weeks) giving advice on healthy eating based on a Mediterranean diet and physical exercise. The recommendations given were the following: 5 portions of fruit/vegetables per day, a diet low in absolute fat, a preference of vegetable oil (olive or rapeseed oil), whole-grain products, poultry, low-fat dairy products, 1 fat and 1 lean fish meal per week, reduced consumption of red meat, and avoidance of pork, ready-made meals, sugar and excessive salt intake. In addition, regular consumption of 1 bar of dark chocolate (25 g, >70% of cacao), 1-2 tomatoes, and 3-5 walnuts as well as at least 30 min of moderate daily physical activity were recommended. Within these two groups, half of the patients were randomized either to avoid alcohol completely or to drink 100 ml (women) or 200 ml of red wine (men) daily. RESULTS Neither LC nor red wine had an effect on the mean systolic and diastolic 24-hour BP and HR after 4 and 20 weeks, as analyzed by general linear modeling. No difference was found for diurnal and nocturnal values. CONCLUSIONS The possible beneficial effect of regular consumption of small amounts of red wine is not counterbalanced in the long term by an increase in the mean BP or HR in mainly normotensive and well-treated hypertensive patients with carotid atherosclerosis, neither in the patients given healthy lifestyle advice nor in those with a standard lifestyle. Yet, we remain cautious about actively advice patients to drink alcohol regularly given the well-known risks.
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Affiliation(s)
- Dirk W Droste
- Department of Neurology, Centre Hospitalier de Luxembourg, Luxembourg, Luxemburg
| | | | | | | | | | | | - Telma Velez
- Clinical and Epidemiological Investigation Centre, Luxemburg
| | - Michèle Meyer
- Clinical and Epidemiological Investigation Centre, Luxemburg
| | - Tessy Guth
- Methodology and Statistical Competence Centre, Luxemburg
| | - Andrea Kuemmerle
- Centre of Health Studies, Centre de Recherche Public-Santé, Strassen, Luxemburg
| | - Anna Chioti
- Clinical and Epidemiological Investigation Centre, Luxemburg
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Poli A, Marangoni F, Avogaro A, Barba G, Bellentani S, Bucci M, Cambieri R, Catapano AL, Costanzo S, Cricelli C, de Gaetano G, Di Castelnuovo A, Faggiano P, Fattirolli F, Fontana L, Forlani G, Frattini S, Giacco R, La Vecchia C, Lazzaretto L, Loffredo L, Lucchin L, Marelli G, Marrocco W, Minisola S, Musicco M, Novo S, Nozzoli C, Pelucchi C, Perri L, Pieralli F, Rizzoni D, Sterzi R, Vettor R, Violi F, Visioli F. Moderate alcohol use and health: a consensus document. Nutr Metab Cardiovasc Dis 2013; 23:487-504. [PMID: 23642930 DOI: 10.1016/j.numecd.2013.02.007] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 01/29/2013] [Accepted: 02/27/2013] [Indexed: 02/07/2023]
Abstract
AIMS The aim of this consensus paper is to review the available evidence on the association between moderate alcohol use, health and disease and to provide a working document to the scientific and health professional communities. DATA SYNTHESIS In healthy adults and in the elderly, spontaneous consumption of alcoholic beverages within 30 g ethanol/d for men and 15 g/d for women is to be considered acceptable and do not deserve intervention by the primary care physician or the health professional in charge. Patients with increased risk for specific diseases, for example, women with familiar history of breast cancer, or subjects with familiar history of early cardiovascular disease, or cardiovascular patients should discuss with their physician their drinking habits. No abstainer should be advised to drink for health reasons. Alcohol use must be discouraged in specific physiological or personal situations or in selected age classes (children and adolescents, pregnant and lactating women and recovering alcoholics). Moreover, the possible interactions between alcohol and acute or chronic drug use must be discussed with the primary care physician. CONCLUSIONS The choice to consume alcohol should be based on individual considerations, taking into account the influence on health and diet, the risk of alcoholism and abuse, the effect on behaviour and other factors that may vary with age and lifestyle. Moderation in drinking and development of an associated lifestyle culture should be fostered.
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Affiliation(s)
- A Poli
- NFI (Nutrition Foundation of Italy), Viale Tunisia 38, 20124 Milan, Italy.
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50
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Abstract
The relationship between alcohol consumption and health outcomes has a long history and has generated much research. Heavy drinking is detrimental to health; however, there is considerable and convincing evidence from both short-term biochemical experimental studies and observational studies of a beneficial association with certain health outcomes related to atherosclerotic processes. This beneficial association is most important for an average alcohol intake of one to two drinks per day. Important factors in determining the magnitude or direction of effects have been identified. Most criticisms based on methodological issues have been dismissed in recent years from an epidemiological point of view. However, important questions remain about the circumstances of such a beneficial association. The net effect of alcohol consumption on health outcomes is detrimental overall, owing to the negative effect of cancers, infectious disease, gastrointestinal diseases, alcohol-use disorders and injuries.
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Affiliation(s)
- Michael Roerecke
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON M5S 2S1, Canada.
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