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Cao Z, Zhang J, Lu Z, Chen H, Min J, Hou Y, Wang X, Xu C. Physical Activity, Mental Activity, and Risk of Incident Stroke: A Prospective Cohort Study. Stroke 2024; 55:1278-1287. [PMID: 38533647 DOI: 10.1161/strokeaha.123.044322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 02/28/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Cumulative evidence suggests a correlation between physical or mental activity and the risk of stroke. However, the combined impact of these activities on stroke onset remains unexplored. This study identified physical and mental activity patterns using principal component analysis and investigated their associations with risk of incident stroke in the general population. METHODS Our study was sourced from the UK Biobank cohort between 2006 and 2010. Information on physical and mental-related activities were obtained through a touch-screen questionnaire. The incident stroke was diagnosed by physicians and subsequently verified through linkage to Hospital Episode Statistics. Principal component analysis was used to identify potential physical and mental activity patterns. Cox proportional hazard regression models were performed to calculate hazard ratios (HRs) and 95% CIs of incident stroke, adjusting for potential confounders. RESULTS The initial UK Biobank cohort originally consisted of 502 411 individuals, of whom a total of 386 902 participants (aged 38-79 years) without any history of stroke at baseline were included in our study. During a median follow-up of 7.7 years, 6983 (1.8%) cases of stroke were documented. The mean age of the included participants was 55.9 years, and the proportion of women was 55.1%. We found that multiple individual items related to physical and mental activity showed significant associations with risk of stroke. We identified 4 patterns of physical activity and 3 patterns of mental activity using principal component analysis. The adherence to activity patterns of vigorous exercise, housework, and walking predominant patterns were associated with a lower risk of stroke by 17% (HR, 0.83 [95% CI, 0.78-0.89]; 20% (HR, 0.80 [95% CI, 0.75-0.85]; and 20% (HR, 0.80 [95% CI, 0.75-0.86), respectively. Additionally, the transportation predominant pattern (HR, 1.36 [95% CI, 1.28-1.45) and watching TV pattern (HR, 1.43 [95% CI, 1.33-1.53) were found to be significantly associated with a higher risk of stroke. These associations remained consistent across all subtypes of stroke. CONCLUSIONS Activity patterns mainly related to frequent vigorous exercise, housework, and walking were associated with lower risks of stroke and all its subtypes. Our findings provide new insights for promoting suitable patterns of physical and mental activity for primary prevention of stroke.
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Affiliation(s)
- Zhi Cao
- School of Public Health, Hangzhou Normal University, China (Z.C., J.Z., H.C., J.M., X.W., C.X.)
- School of Public Health, Zhejiang University, Hangzhou, China (Z.C.)
| | - Jing Zhang
- School of Public Health, Hangzhou Normal University, China (Z.C., J.Z., H.C., J.M., X.W., C.X.)
| | - Zuolin Lu
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands (Z.L.)
| | - Han Chen
- School of Public Health, Hangzhou Normal University, China (Z.C., J.Z., H.C., J.M., X.W., C.X.)
| | - Jiahao Min
- School of Public Health, Hangzhou Normal University, China (Z.C., J.Z., H.C., J.M., X.W., C.X.)
| | - Yabing Hou
- Yanjing Medical College, Capital Medical University, Beijing, China (Y.H.)
| | - Xiaohe Wang
- School of Public Health, Hangzhou Normal University, China (Z.C., J.Z., H.C., J.M., X.W., C.X.)
- Hangzhou International Urbanology Research Center and Center for Urban Governance Studies, China (X.W., C.X.)
| | - Chenjie Xu
- School of Public Health, Hangzhou Normal University, China (Z.C., J.Z., H.C., J.M., X.W., C.X.)
- Hangzhou International Urbanology Research Center and Center for Urban Governance Studies, China (X.W., C.X.)
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2
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Musich M, Costa AN, Salathe V, Miller MB, Curtis AF. Sex-Specific Contributions of Alcohol and Hypertension on Everyday Cognition in Middle-Aged and Older Adults. J Womens Health (Larchmt) 2023; 32:1086-1095. [PMID: 37023399 DOI: 10.1089/jwh.2022.0462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Background: Separate lines of research have linked hypertension and alcohol use disorder to cognition among adults. Despite known sex differences in both of these conditions, studies examining associations on cognition are limited. We aimed to determine whether hypertension impacts the relationship between alcohol use and everyday subjective cognition and whether sex moderates this relationship in middle-aged and older adults. Materials and Methods: Participants (N = 275) 50+ years of age, who reported drinking, completed surveys measuring alcohol use (Alcohol Use Disorder Identification Test consumption items), self-reported history of hypertension, and everyday subjective cognition (Cognitive Failures Questionnaire [CFQ]). Regression was used to test a moderated moderation model examining independent and interactive roles of alcohol use, hypertension, and sex on cognition (CFQ scores: total, memory, distractibility, blunders, and names). Analyses controlled for age, years of education, race, body mass index, smoking status, depressive symptoms, global subjective sleep quality, number of prescription medication used, and number of comorbid medical conditions. Results: Sex moderated the interactive associations of hypertension and alcohol use frequency on CFQ-distractibility. Specifically, in women with hypertension, more alcohol use was associated with greater CFQ-distractibility (B = 0.96, SE = 0.34, p = 0.005). Discussion: Sex moderates the interactive association of hypertension and alcohol use on some aspects of subjective cognition in mid-to-late life. In women with hypertension, alcohol use may exacerbate problems with attentional control. Further exploration of sex- and or gender-specific mechanisms underlying these is warranted.
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Affiliation(s)
- Madison Musich
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Amy N Costa
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Victoria Salathe
- Department of Biological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Mary Beth Miller
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Ashley F Curtis
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri, USA
- College of Nursing, University of South Florida, Tampa, Florida, USA
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3
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Roa-Díaz ZM, Teuscher J, Gamba M, Bundo M, Grisotto G, Wehrli F, Gamboa E, Rojas LZ, Gómez-Ochoa SA, Verhoog S, Vargas MF, Minder B, Franco OH, Dehghan A, Pazoki R, Marques-Vidal P, Muka T. Gene-diet interactions and cardiovascular diseases: a systematic review of observational and clinical trials. BMC Cardiovasc Disord 2022; 22:377. [PMID: 35987633 PMCID: PMC9392936 DOI: 10.1186/s12872-022-02808-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Both genetic background and diet are important determinants of cardiovascular diseases (CVD). Understanding gene-diet interactions could help improve CVD prevention and prognosis. We aimed to summarise the evidence on gene-diet interactions and CVD outcomes systematically. METHODS We searched MEDLINE® via Ovid, Embase, PubMed®, and The Cochrane Library for relevant studies published until June 6th 2022. We considered for inclusion cross-sectional, case-control, prospective cohort, nested case-control, and case-cohort studies as well as randomised controlled trials that evaluated the interaction between genetic variants and/or genetic risk scores and food or diet intake on the risk of related outcomes, including myocardial infarction, coronary heart disease (CHD), stroke and CVD as a composite outcome. The PROSPERO protocol registration code is CRD42019147031. RESULTS AND DISCUSSION We included 59 articles based on data from 29 studies; six articles involved multiple studies, and seven did not report details of their source population. The median sample size of the articles was 2562 participants. Of the 59 articles, 21 (35.6%) were qualified as high quality, while the rest were intermediate or poor. Eleven (18.6%) articles adjusted for multiple comparisons, four (7.0%) attempted to replicate the findings, 18 (30.5%) were based on Han-Chinese ethnicity, and 29 (49.2%) did not present Minor Allele Frequency. Fifty different dietary exposures and 52 different genetic factors were investigated, with alcohol intake and ADH1C variants being the most examined. Of 266 investigated diet-gene interaction tests, 50 (18.8%) were statistically significant, including CETP-TaqIB and ADH1C variants, which interacted with alcohol intake on CHD risk. However, interactions effects were significant only in some articles and did not agree on the direction of effects. Moreover, most of the studies that reported significant interactions lacked replication. Overall, the evidence on gene-diet interactions on CVD is limited, and lack correction for multiple testing, replication and sample size consideration.
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Affiliation(s)
- Zayne M Roa-Díaz
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland. .,Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - Julian Teuscher
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Magda Gamba
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.,Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Marvin Bundo
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.,Graduate School for Health Sciences, University of Bern, Bern, Switzerland.,Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Giorgia Grisotto
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.,Graduate School for Health Sciences, University of Bern, Bern, Switzerland.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Faina Wehrli
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Edna Gamboa
- School of Nutrition and Dietetics, Health Faculty, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Lyda Z Rojas
- Nursing Research and Knowledge Development Group GIDCEN, Fundación Cardiovascular de Colombia, Floridablanca, Colombia
| | - Sergio A Gómez-Ochoa
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Sanne Verhoog
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.,Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Beatrice Minder
- Public Health & Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland
| | - Oscar H Franco
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.,Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
| | - Raha Pazoki
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK.,Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.,CIRTM Centre for Inflammation Research and Translational Medicine, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
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4
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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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5
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Lin PBC, Wang PK, Pang CY, Hu WF, Tsai APY, Oblak AL, Liew HK. Moderate Ethanol Pre-treatment Mitigates ICH-Induced Injury via ER Stress Modulation in Rats. Front Mol Neurosci 2021; 14:682775. [PMID: 34248500 PMCID: PMC8267178 DOI: 10.3389/fnmol.2021.682775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/26/2021] [Indexed: 11/29/2022] Open
Abstract
Intracerebral hemorrhage (ICH) is a life-threatening type of stroke that disrupts the normal neurological function of the brain. Clinical studies have reported a non-linear J-shaped association between alcohol consumption levels and the occurrence of cerebral stroke. Specifically, alcohol intoxication increases stroke incidence, while moderate alcohol pre-conditioning decreases stroke frequency and improves outcomes. Although alcohol pre-consumption is likely a crucial player in ICH, the underlying mechanism remains unclear. We performed 1-h alcohol pre-conditioning followed by ICH induction in Sprague-Dawley (SD) rats to investigate the role of alcohol pre-conditioning in ICH. Interestingly, behavioral test analysis found that ethanol intoxication (3 g/kg) aggravated ICH-induced neurological deficits, but moderate ethanol pre-conditioning (0.75 g/kg) ameliorated ICH-induced neurological deficits by reducing the oxidative stress and proinflammatory cytokines release. Moreover, we found that moderate ethanol pretreatment improved the striatal endoplasmic reticulum (ER) homeostasis by increasing the chaperone protein expression and reducing oxidative stress and apoptosis caused by ICH. Our findings show that the mechanism regulated by moderate ethanol pre-conditioning might be beneficial for ICH, indicating the importance of ER homeostasis, oxidative stress, and differential cytokines release in ICH.
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Affiliation(s)
- Peter Bor-Chian Lin
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Po-Kai Wang
- Department of Anesthesiology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Cheng-Yoong Pang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Wei-Fen Hu
- Department of Pharmacology and Toxicology, Tzu Chi University, Hualien, Taiwan
| | - Andy Po-Yi Tsai
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Adrian L Oblak
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Hock-Kean Liew
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,Department of Pharmacology and Toxicology, Tzu Chi University, Hualien, Taiwan.,Neuro-Medical Scientific Center, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
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6
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Categorising a problem: alcohol and dementia. Acta Neurol Belg 2021; 121:1-10. [PMID: 33052532 DOI: 10.1007/s13760-020-01515-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/28/2020] [Indexed: 12/15/2022]
Abstract
Alcoholism is a chronic relapsing disorder that can include extended periods of abstinence followed by relapse to heavy drinking. Decades of evidence have clearly shown that long-term, chronic ethanol exposure produces brain damage in humans. The article aims to review the relationship between alcohol use and dementia. Medline and Google Scholar searches were conducted for relevant articles, chapters and books published until 2019. Search terms used included alcohol consumption, alcohol-related dementia, alcohol use disorders, chronic alcoholism, dementia. Publications found through this indexed search were reviewed for further relevant references. Alcohol acts on the central nervous system via both direct and indirect effects, frequently a combination of the two. There is consensus that alcohol contributes to the acquisition of cognitive deficits in late life. However, there are doubts regarding the aetiopathogenesis, nosological status and prevalence of alcohol-related dementia and still, there is much debate over how much alcohol consumption will lead to alcohol-related dementia.
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7
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Maugeri A, Hlinomaz O, Agodi A, Barchitta M, Kunzova S, Bauerova H, Sochor O, Medina-Inojosa JR, Lopez-Jimenez F, Vinciguerra M, Stokin GB, González-Rivas JP. Is Drinking Alcohol Really Linked to Cardiovascular Health? Evidence from the Kardiovize 2030 Project. Nutrients 2020; 12:nu12092848. [PMID: 32957567 PMCID: PMC7551763 DOI: 10.3390/nu12092848] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 12/28/2022] Open
Abstract
Existing data have described benefits and drawbacks of alcohol consumption on cardiovascular diseases (CVD), but no research has evaluated its association with the cardiovascular health (CVH) score proposed by the American Heart Association. Here, we conducted a cross-sectional analysis on the Kardiovize cohort (Brno, Czech Republic), to investigate the relationship between alcohol consumption and CVH. We included 1773 subjects (aged 25–64 years; 44.2% men) with no history of CVD. We compared CVD risk factors, CVH metrics (i.e., BMI, healthy diet, physical activity level, smoking status, blood pressure, fasting glucose, and total cholesterol) and CVH score between and within several drinking categories. We found that the relationship between drinking habits and CVH was related to the amount of alcohol consumed, drinking patterns, and beverage choices. Heavy drinkers were more likely to smoke tobacco, and to report diastolic blood pressure, fasting glucose, triglycerides, and low-density lipoprotein (LDL)-cholesterol at higher level than non-drinkers. Among drinkers, however, people who exclusively drank wine exhibited better CVH than those who exclusively drank beer. Although our findings supported the hypothesis that drinking alcohol was related to the CVH in general, further prospective research is needed to understand whether the assessment of CVH should incorporate information on alcohol consumption.
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Affiliation(s)
- Andrea Maugeri
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95127 Catania, Italy; (A.A.); (M.B.)
- Correspondence:
| | - Ota Hlinomaz
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95127 Catania, Italy; (A.A.); (M.B.)
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95127 Catania, Italy; (A.A.); (M.B.)
| | - Sarka Kunzova
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
| | - Hana Bauerova
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
| | - Ondrej Sochor
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
| | - Jose R. Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic and Mayo Medical School, Rochester, MI 55905, USA; (J.R.M.-I.); (F.L.-J.)
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic and Mayo Medical School, Rochester, MI 55905, USA; (J.R.M.-I.); (F.L.-J.)
| | - Manlio Vinciguerra
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
| | - Gorazd Bernard Stokin
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
| | - Juan Pablo González-Rivas
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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8
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Wang M, Xie Y, Zhao S, Wang Y, Cui J, Chang S. Association of alcohol consumption with prognosis of ischemic stroke by subtype in different follow-up periods: a hospital-based study in China. Postgrad Med 2020; 133:154-159. [PMID: 33522353 DOI: 10.1080/00325481.2020.1805945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Alcohol consumption is a risk factor for stroke. However, there are no available data on the effect of alcohol consumption on the long-term outcome of ischemic stroke in China. Therefore, this study aimed to explore the association of alcohol consumption with the prognosis of ischemic stroke by subtype in different follow-up periods after stroke. METHODS This 12-month follow-up study recruited 3830 acute ischemic stroke patients from Tianjin, China, between 2016 and 2018. Patients were categorized into two groups according to their consumption of alcohol. Differences in mortality, recurrence, and dependency rates at 3 and 12 months after stroke were compared between both groups. RESULTS The mortality, recurrence, and dependency rates at 12 months after stroke were significantly higher in patients who previously consumed alcohol than in those without previous alcohol consumption (all P < 0.005). A similar trend was observed for mortality rate at 3 months after stroke (P < 0.001). The risk of death at 3 months after an atherothrombotic stroke decreased by 63.4% (relative risk [RR], 0.366; 95% confidence interval [CI], 0.144-0.935) among patients who previously consumed alcohol compared with those who never consumed alcohol. Moreover, for patients with small artery disease classified according to the Trial of ORG 10,172 in Acute Stroke Treatment (TOAST), the recurrence and dependency rates at 12 months after stroke decreased by 49.2% (RR, 0.508; 95% CI, 0.259-0.996) and 49.5% (RR, 0.505; 95% CI, 0.258-0.990), respectively, among patients who consumed alcohol. CONCLUSIONS Previous alcohol consumption decreased the risk of death at 3 months after stroke among patients with atherothrombotic stroke according to the TOAST classification. Furthermore, for patients with small artery disease (according to TOAST classification), alcohol consumption significantly decreased the risk of recurrence and dependency at 12 months after stroke. This study highlights an urgent need to quantify the association of alcohol consumption with outcomes after stroke in China to improve stroke prognosis.
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Affiliation(s)
- Min Wang
- Department of Neurology, Dongying People's Hospital, Dongying, Shandong Province, China
| | - Yuanli Xie
- Department of Neurology, Dongying People's Hospital, Dongying, Shandong Province, China
| | - Suzhen Zhao
- Department of Oncology, Dongying People's Hospital, Dongying, Shandong Province, China
| | - Yucui Wang
- Department of Neurology, Dongying People's Hospital, Dongying, Shandong Province, China
| | - Jingjing Cui
- Department of Neurology, Dongying People's Hospital, Dongying, Shandong Province, China
| | - Shihui Chang
- Department of Neurology, Dongying People's Hospital, Dongying, Shandong Province, China
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9
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Singer J, Gustafson D, Cummings C, Egelko A, Mlabasati J, Conigliaro A, Levine SR. Independent ischemic stroke risk factors in older Americans: a systematic review. Aging (Albany NY) 2020; 11:3392-3407. [PMID: 31127075 PMCID: PMC6555455 DOI: 10.18632/aging.101987] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 04/04/2019] [Indexed: 11/25/2022]
Abstract
The Framingham Stroke Risk Profile (FSRP) is a validated model for predicting 10-year ischemic stroke risk in middle-aged adults, yet has not been demonstrated to consistently translate in older populations. This is a systematic review of independent risk factors measured among > 65 year olds, with subsequent first ischemic stroke, using PRISMA guidelines. We appraised peer-reviewed publications that included participants > 65 years old at risk assessment. Combined with other criteria, results were abstracted from 28 papers reporting six types of stroke risk factors: Serologic/Diagnostic, Conventional, Psychosocial, Genetic, Cognitive, and Antibiotic use. These studies demonstrated levels of serum androgens, C-reactive protein, and advanced glycation endproducts; thrombin generation; left ventricular mass; depressive symptoms; phosphodiesterase 4D single nucleotide polymorphisms; coagulation factor XII gene; peak thrombus generation; and lower cognitive functioning were independent risk factors for ischemic stroke in older adults. Plasma adipokines, free fatty acids and antibiotic use did not predict ischemic stroke. Purpose in life and APOEε2 allele were protective for ischemic stroke. This systematic review provides evidence of risk and protective factors for ischemic stroke in older cohorts that are not included in the FSRP. Further studies are needed to understand whether these factors are important enough to comprise a risk score.
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Affiliation(s)
- Jonathan Singer
- Department of Clinical Psychology, University of Nevada, Reno, NV 89557, USA
| | - Deborah Gustafson
- Department of Neurology, Section for NeuroEpidemiology, State University of New York Downstate Medical Center, Brooklyn, NY 11203, USA
| | - Caroline Cummings
- Department of Clinical Psychology, University of Nevada, Reno, NV 89557, USA
| | - Aron Egelko
- State University of New York Downstate Medical Center, Department of Neurology and Stroke Center, New York City Health + Hospitals/Kings County, Brooklyn, NY 11203, USA
| | | | - Alyssa Conigliaro
- Department of Clinical Psychology, Hofstra University, Hempstead, NY 11549, USA
| | - Steven R Levine
- State University of New York Downstate Medical Center, Department of Neurology and Stroke Center, New York City Health + Hospitals/Kings County, Brooklyn, NY 11203, USA
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10
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Han J, Mao W, Ni J, Wu Y, Liu J, Bai L, Shi M, Tu J, Ning X, Wang J. Rate and Determinants of Recurrence at 1 Year and 5 Years After Stroke in a Low-Income Population in Rural China. Front Neurol 2020; 11:2. [PMID: 32038470 PMCID: PMC6989474 DOI: 10.3389/fneur.2020.00002] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/02/2020] [Indexed: 01/07/2023] Open
Abstract
Recurrent stroke is becoming an increasingly important public health issue owing to the increased risk of disability and death. However, population-based studies investigating the rate of recurrent stroke in China are rare. We explored the rate and determinants of recurrent stroke within 1 and 5 years after the initial stroke in a rural population in China. Data for stroke events were obtained from the Tianjin Brain Study, conducted between 1992 and 2016. The age-standardized rates of recurrent stroke within the first year and the first 5 years after the initial stroke were calculated for this period. Determinants of recurrent stroke were assessed using Cox regression analyses. The overall age-standardized rate of recurrent stroke within 1 year was 5.7% (men, 6.9%; women, 4.6%); within 5 years, the overall recurrent stroke rate was 22.5% (men, 24.0%; women, 20.2%). The recurrence rate increased with advancing age and decreased with increased educational attainment. Age ≥65 years and a history of alcohol consumption were independent risk factors for recurrent stroke within 1 year after the incident stroke, after adjusting for age, sex, education, hypertension, diabetes, smoking, and alcohol consumption. However, the risk of recurrent stroke within 5 years after the incident stroke was positively associated with male sex, age ≥65 years, a lower level of education, known diabetes, and alcohol consumption, after adjusting for the previously indicated covariates. These findings suggest a crucial need to address risk factor management among stroke patients to reduce the burden of stroke, especially among low-income populations. Furthermore, a multicenter, large sample, nationwide study is urgently needed.
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Affiliation(s)
- Jing Han
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wenjing Mao
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Neurology, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Jingxian Ni
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Yanan Wu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Lingling Bai
- Department of Neurology, Liaocheng People's Hospital, Liaocheng, China
| | - Min Shi
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
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11
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Susmitha K, Chandrasekhar V, Kiran G, Divya A, Rani GS, Sarangapani M. Prevalence of Stroke Cases in Warangal, Telangana Region, India: A Hospital-Based Case Study. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1196:109-115. [DOI: 10.1007/978-3-030-32637-1_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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12
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Cheng YC, Huang YC, Huang WL. Heart rate variability as a potential biomarker for alcohol use disorders: A systematic review and meta-analysis. Drug Alcohol Depend 2019; 204:107502. [PMID: 31494439 DOI: 10.1016/j.drugalcdep.2019.05.030] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/11/2019] [Accepted: 05/28/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND Alcohol use disorders (AUDs) have been found to be associated with elevated cardiovascular risk. The autonomic nervous system is considered to play a role in this association. Heart rate variability (HRV) has been employed to measure parasympathetic activity in AUDs patients in some studies; however, the results are not consistent, and the adopted HRV indices vary across studies. A meta-analysis should be helpful for clarifying this topic. METHODS We gathered studies about measuring HRV in AUDs patients and healthy participants from databases. HRV was analyzed in several ways: parasympathetic function in hierarchical order (main analysis), total variability, and specific parasympathetic indices. Specific parasympathetic indices were further separated into high-frequency power (HF) and root mean square of the successive differences (RMSSD). For comparing the above values in patients with AUDs and in healthy individuals, we adopted the random effects model to calculate the standardized mean difference. RESULTS Of the 144 screened studies, 15 were included in the quantitative analysis. In the comparison of parasympathetic function in hierarchical order, HRV in AUDs patients was significantly lower than in healthy individuals (Hedges'g = -0.4301, 95% CI [-0.7601 to -0.1000], p=0.0106, I2 = 83.8%). Regarding total variability and RMSSD, AUDs patients also had significantly lower values than healthy controls. However, the differences of specific parasympathetic indices and HF were not significantly different. CONCLUSION Our results support the view that AUDs patients have reduced parasympathetic activity. Total variability and RMSSD are suitable indices for presenting reduced HRV in patients with AUDs.
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Affiliation(s)
- Ying-Chih Cheng
- Department of Psychiatry, Taoyuan Psychiatric Center Ministry of Health and Welfare, 71, Longshou Street, Taoyuan District, Taoyuan City 33058, Taiwan, ROC; Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, Taipei 10055, Taiwan, ROC; Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, No. 250 Wuxing St., Taipei 11031, Taiwan, ROC
| | - Yu-Chen Huang
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, No. 250 Wuxing St., Taipei 11031, Taiwan, ROC; Department of Dermatology, Wan Fang Hospital, Taipei Medical University, 111, Hsing-Long Road Sec. 3, Wenshan District, Taipei City 11696, Taiwan, ROC; Department of Dermatology, School of Medicine and College of Medicine, Taipei Medical University, No. 250 Wuxing St., Taipei 11031, Taiwan, ROC
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, No. 579, Sec. 2, Yunlin Rd., Douliu City, Yunlin County 64041, Taiwan, ROC; Department of Psychiatry, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City 10002, Taiwan, ROC; Department of Psychiatry, College of Medicine, National Taiwan University, No. 1, Sec. 1, Ren'ai Rd., Zhongzheng Dist., Taipei City 10051, Taiwan, ROC; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City 10002, Taiwan, ROC.
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13
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Timko C, Johnson JE, Kurth M, Schonbrun YC, Anderson BJ, Stein MD. Health Services Use Among Jailed Women with Alcohol Use Disorders. J Behav Health Serv Res 2019; 46:116-128. [PMID: 30238292 DOI: 10.1007/s11414-018-9634-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Correctional facilities now house unprecedented numbers of women with complex treatment needs. This investigation applied the Behavioral Model for Vulnerable Populations to study 168 jailed women with alcohol use disorders. It described the sample's predisposing (age, race, victimization), enabling (health insurance), and need (self-reported medical, substance use, and mental health problems) factors and examined associations of these factors with pre-incarceration services utilization. Most participants had clinically significant levels of depression and PTSD symptoms, most took psychiatric medications, and most had been victimized. Participants reported considerable health services utilization. Younger, Black, and uninsured women utilized fewer medical and mental health services. Drug use was associated with less use of medical services, but more use of alcohol and drug services. High rates of health services use support the need for integrated, ongoing care for substance-using women before, during, and after incarceration.
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Affiliation(s)
- Christine Timko
- Center for Innovation to Implementation, VA Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road, Menlo Park, CA, 94025, USA.
| | - Jennifer E Johnson
- Division of Public Health, College of Human Medicine, Michigan State University, 200 East 1st Street, Flint, MI, 48502, USA
| | - Megan Kurth
- Behavioral Medicine and Addictions Research, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA
| | - Yael Chatav Schonbrun
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, 222 Richmond St, Providence, RI, 02903, USA
| | - Bradley J Anderson
- Behavioral Medicine and Addictions Research, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA
| | - Michael D Stein
- Behavioral Medicine and Addictions Research, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA.,Department of Health Law, Policy, & Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA
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14
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Mediterranean diet: The role of long-chain ω-3 fatty acids in fish; polyphenols in fruits, vegetables, cereals, coffee, tea, cacao and wine; probiotics and vitamins in prevention of stroke, age-related cognitive decline, and Alzheimer disease. Rev Neurol (Paris) 2019; 175:724-741. [PMID: 31521398 DOI: 10.1016/j.neurol.2019.08.005] [Citation(s) in RCA: 207] [Impact Index Per Article: 41.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 08/28/2019] [Indexed: 12/18/2022]
Abstract
The mechanisms of action of the dietary components of the Mediterranean diet are reviewed in prevention of cardiovascular disease, stroke, age-associated cognitive decline and Alzheimer disease. A companion article provides a comprehensive review of extra-virgin olive oil. The benefits of consumption of long-chain ω-3 fatty acids are described. Fresh fish provides eicosapentaenoic acid while α-linolenic acid is found in canola and soybean oils, purslane and nuts. These ω-3 fatty acids interact metabolically with ω-6 fatty acids mainly linoleic acid from corn oil, sunflower oil and peanut oil. Diets rich in ω-6 fatty acids inhibit the formation of healthier ω-3 fatty acids. The deleterious effects on lipid metabolism of excessive intake of carbohydrates, in particular high-fructose corn syrup and artificial sweeteners, are explained. The critical role of the ω-3 fatty acid docosahexaenoic acid in the developing and aging brain and in Alzheimer disease is addressed. Nutritional epidemiology studies, prospective population-based surveys, and clinical trials confirm the salutary effects of fish consumption on prevention of coronary artery disease, stroke and dementia. Recent recommendations on fish consumption by pregnant women and potential mercury toxicity are reviewed. The polyphenols and flavonoids of plant origin play a critical role in the Mediterranean diet, because of their antioxidant and anti-inflammatory properties of benefit in type-2 diabetes mellitus, cardiovascular disease, stroke and cancer prevention. Polyphenols from fruits and vegetables modulate tau hyperphosphorylation and beta amyloid aggregation in animal models of Alzheimer disease. From the public health viewpoint worldwide the daily consumption of fruits and vegetables has become the main tool for prevention of cardiovascular disease and stroke. We review the important dietary role of cereal grains in prevention of coronary disease and stroke. Polyphenols from grapes, wine and alcoholic beverages are discussed, in particular their effects on coagulation. The mechanisms of action of probiotics and vitamins are also included.
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15
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Lordan R, O’Keeffe E, Dowling D, Mullally M, Heffernan H, Tsoupras A, Zabetakis I. The in vitro antithrombotic properties of ale, lager, and stout beers. FOOD BIOSCI 2019. [DOI: 10.1016/j.fbio.2019.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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16
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Recurrence Rate and Relevant Associated Factors of Stroke among Patients with Small Artery Occlusion in Northern China. Sci Rep 2019; 9:2834. [PMID: 30808986 PMCID: PMC6391422 DOI: 10.1038/s41598-019-39207-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/14/2019] [Indexed: 12/22/2022] Open
Abstract
Small artery occlusion (SAO) is responsible for 31.3% of all ischemic strokes in China. However, reports regarding the recurrence rate of SAO in China are rare. We aimed to assess the recurrence rate and factors associated with SAO in China. All consecutive patients with SAO hospitalized at Tianjin Huanhu Hospital from 2005 to 2014 were recruited. We assessed the association between stroke subtype, severity, and disease history with recurrence at 3, 12, and 36 months of onset using multivariate logistic regression analysis. A total of 2,524 SAO patients were included in this study, including 1696 (67.2%) men and 828 (32.8%) women. The recurrence rates were 3.1% at 3 months, 12.7% at 12 months, and 36.5% at 36 months. Compared with women, men had a higher risk of recurrence at 3 months after SAO (P = 0.003). Old age and severity of stroke were also associated with a higher risk of recurrence (P < 0.05). Patients with an elevated C-reactive protein had a higher risk of recurrence at 12 months (P = 0.003). On the other hand, the risk of recurrence at 12 months was 39% lower in patients who consumed alcohol than in those who did not (P = 0.037). Hypertension, atrial fibrillation, and obesity were independent risk factors of recurrence at 36 months. These findings suggest that modification of risk factors in patients with SAO, particularly men, is essential for reducing the rate of recurrence and the overall burden of stroke in China.
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17
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Woodhead EL, Booth BM, Timko C, Tjemsland A, Han X, Cucciare MA. Longitudinal Health Outcomes and Treatment Utilization Among Emerging, Early-Mid, and Older Rural Adults Using Stimulants. JOURNAL OF ADULT DEVELOPMENT 2018. [DOI: 10.1007/s10804-018-9309-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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18
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Christensen AI, Nordestgaard BG, Tolstrup JS. Alcohol Intake and Risk of Ischemic and Haemorrhagic Stroke: Results from a Mendelian Randomisation Study. J Stroke 2018; 20:218-227. [PMID: 29886720 PMCID: PMC6007300 DOI: 10.5853/jos.2017.01466] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 11/24/2017] [Accepted: 12/24/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND AND PURPOSE To test whether alcohol intake, both observational and estimated by genetic instruments, is associated with risk of ischemic and haemorrhagic stroke. METHODS We used data from the Copenhagen City Heart Study 1991 to 1994 and 2001 to 2003, and the Copenhagen General Population Study 2003 to 2012 (n=78,546). As measure of alcohol exposure, self-reported consumption and genetic variation in alcohol metabolizing genes (alcohol dehydrogenase ADH1B and ADH1C) as instrumental variables were used. Stroke diagnoses were obtained from a validated hospital register. RESULTS During follow-up 2,535 cases of ischemic and haemorrhagic stroke occurred. Low and moderate alcohol intake (1 to 20 drinks/week) was associated with reduced risk of stroke. The hazard ratios associated with drinking 1 to 6, 7 to 13, and 14 to 20 drinks/week were 0.84 (95% confidence interval [CI], 0.76 to 0.92), 0.83 (95% CI, 0.73 to 0.94), and 0.84 (95% CI, 0.73 to 0.97), respectively, compared with drinking <1 drink/day. ADH1B and ADH1C genotypes were not associated with risk of stroke. Further analysis to test the included measures revealed that increasing alcohol intake (per 1 drink/day) was positively associated with risk of alcoholic liver cirrhosis, but not associated with risk of stroke, and that increasing blood pressure (per systolic 10 mm Hg) was not associated with risk of alcoholic liver cirrhosis, but positively associated with risk of stroke. CONCLUSIONS Low and moderate self-reported alcohol intake was associated with reduced risk of stroke. The result was not supported by the result from the causal genetic analysis.
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Affiliation(s)
- Anne I Christensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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19
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Li H, Xu W, Jiang L, Gu H, Li M, Zhang J, Guo W, Deng P, Long H, Bu Q, Tian J, Zhao Y, Cen X. Lipidomic signature of serum from the rats exposed to alcohol for one year. Toxicol Lett 2018; 294:166-176. [PMID: 29758358 DOI: 10.1016/j.toxlet.2018.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 03/02/2018] [Accepted: 05/08/2018] [Indexed: 02/05/2023]
Abstract
Alcohol abuse and its related diseases are the major risk factors for human health. Although the mechanism of alcohol-related disorders has been widely investigated, serum metabolites associated with long-term alcohol intake have not been well explored. In this study, we aimed to investigate the profiles of serum metabolites and lipid species of rats chronically exposed to alcohol, which may be involved in the pathogenesis of alcohol-associated disease. An 1H NMR-based metabolomics and Q-TOF/MS-based lipidomics approach were applied to investigate the profile of serum metabolites and lipid species of rats administrated daily with alcohol (12% vol/vol, 10 ml/kg per day, i.g.) for one year continuously. The rats administered with sterile water (10 ml/kg per day, i.g.) were used as control. We found that alcohol affected mostly the lipid species rather than small molecule metabolites in the serum of both female and male rats. Among the modified lipids, glycerophospholipid, sphingolipid and glycerolipids metabolism pathways were profoundly altered. The prominent changes in lipid profiles included diacylglycerol (DG), lysophosphatidylcholine (LysoPC), phosphatidic acid (PA), phosphatidylcholine (PC), phosphatidylethanolamine (PE) and triacylglycerol (TG). Moreover, fatty-acyl profile of lipids and total degree of unsaturation of fatty acid were also significantly altered by alcohol. The modified lipidomic profile may help to understand the pathogenesis of alcohol-associated diseases and also be of value for clinical evaluation of alcohol abuse, alcohol-associated disease diagnosis.
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Affiliation(s)
- Hongchun Li
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Wei Xu
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu 610041, China; Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Linhong Jiang
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Hui Gu
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Menglu Li
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Jiamei Zhang
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Wei Guo
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu 610041, China; College of Pharmacy, Yantai University, State Key Laboratory of Long-Acting and Targeting Drug Delivery Technologies, Yantai 264000, China
| | - Pengchi Deng
- Analytical & Testing Center, Sichuan University, Chengdu 610041, China
| | - Hailei Long
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Qian Bu
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu 610041, China; Department of Food Science and Technology, College of Light Industry, Textile and Food Engineering, Sichuan University, Chengdu 610065, China
| | - Jingwei Tian
- College of Pharmacy, Yantai University, State Key Laboratory of Long-Acting and Targeting Drug Delivery Technologies, Yantai 264000, China
| | - Yinglan Zhao
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Xiaobo Cen
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu 610041, China.
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20
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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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 07/13/2017] [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)
| | - 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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21
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Cheng HY, Huang LC, Peng HF, Kuo JS, Liew HK, Pang CY. Delayed formation of hematomas with ethanol preconditioning in experimental intracerebral hemorrhage rats. Tzu Chi Med J 2018; 30:5-9. [PMID: 29643709 PMCID: PMC5883839 DOI: 10.4103/tcmj.tcmj_184_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objective: Spontaneous intracerebral hemorrhage (ICH) accounts for 10%–15% of all strokes and causes high mortality and morbidity. In the previous study, we demonstrated that ethanol could aggravate the severity of brain injury after ICH by increasing neuroinflammation and oxidative stress. In this study, we further investigate the acute effects of ethanol on brain injury within 24 h after ICH. Materials and Methods: Totally, 66 male Sprague-Dawley rats were assigned randomly into two groups: saline pretreatment before ICH (saline + ICH), and ethanol pretreatment before ICH (ethanol + ICH). Normal saline (10 mL/kg) or ethanol (3 g/kg, in 10 mL/kg normal saline) was administered intraperitoneally 1 h before induction of experimental ICH. Bacterial collagenase VII-S (0.23 U in 1.0 μL sterile saline) was injected into the right striatum to induce ICH in the rats. We evaluated the hematoma expansion, hemodynamic parameters (heart rate and blood pressure), activated partial thromboplastin time (aPTT), prothrombin time (PT), and striatal matrix metallopeptidase 9 (MMP-9) expressions at 3, 6, 9, and 24 h after ICH. Results: The ethanol + ICH group exhibited decreased hematoma at 3 h after ICH; nevertheless, there was a larger hematoma compared with the saline + ICH group at 9 and 24 h after ICH. The ethanol + ICH group had lower blood pressure at 3, 6, and 9 h post-ICH, but both groups maintained similar heart rates after ICH. There was no significant difference in the aPTT and PT between the two groups. Incremental ethanol concentrations had no influence on collagenase VII-S activity at 120 min in vitro. MMP-9 expression was upregulated in the right striata of the ethanol + ICH group, especially at 3 and 9 h after ICH. Conclusion: Ethanol delayed hematoma formation in the first 3 h due to a hypotensive effect; however, the accelerated growth of hematomas after 9 h may be a sequela of ethanol-induced MMP-9 activation.
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Affiliation(s)
- Hung-Yu Cheng
- Department of Physical Medicine and Rehabilitation, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Li-Chuan Huang
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.,Department of Radiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Hsiao-Fen Peng
- Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Jon-Son Kuo
- Master Program and PhD Program in Pharmacology and Toxicology, Tzu Chi University, Hualien, Taiwan
| | - Hock-Kean Liew
- Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Cheng-Yoong Pang
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.,Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
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22
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Dietary Polyphenols in the Prevention of Stroke. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:7467962. [PMID: 29204249 PMCID: PMC5674514 DOI: 10.1155/2017/7467962] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 10/04/2017] [Indexed: 11/19/2022]
Abstract
Polyphenols have an important protective role against a number of diseases, such as atherosclerosis, brain dysfunction, stroke, cardiovascular diseases, and cancer. Cardiovascular diseases are the number one cause of death worldwide: more people die annually from cardiovascular diseases than from any other cause. The most important behavioural risk factors of heart disease and stroke are unhealthy diet, physical inactivity, tobacco use, and excess alcohol intake. The dietary consumption of polyphenols has shown to be inversely associated with morbidity and mortality by cardio- and cerebrovascular diseases. It is well-known that the protective effects of polyphenols in vivo depend on the grade how they are extracted from food and on their intestinal absorption, metabolism, and biological action with target tissues. The aim of this review was to summarise the relation between polyphenols of different plant sources and stroke in human intervention studies, animal models, and in vitro studies.
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23
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Kalla A, Figueredo VM. Alcohol and cardiovascular disease in the geriatric population. Clin Cardiol 2017; 40:444-449. [PMID: 28294372 DOI: 10.1002/clc.22681] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 01/06/2017] [Accepted: 01/11/2017] [Indexed: 01/19/2023] Open
Abstract
There has been little focus on the effects of alcohol on the elderly. Although the cardiovascular benefits of moderate alcohol consumption could be of the greatest benefit in this group, so might be the detrimental effects of abuse. In this article, we review available data on the effects of alcohol consumption on cardiovascular disease, cardiomyopathy, arrhythmias, hypertension, and vascular function in older adults. Alcohol consumption has increased in the US population age 65 years and older in the last decade, as has monthly heavy episodic drinking in older alcohol consumers. Studies of alcohol consumption in older subjects suggest that consumption in moderation does not increase the risk of heart failure, hypertension, or atrial arrhythmias, and may in fact improve vascular function and reduce cardiovascular disease events. As in younger subjects, heavy consumption, or abuse of alcohol, negates any potential protective cardiovascular effects, increasing the incidence of heart failure and hypertension. Although alcohol consumed in moderation does not appear harmful in the elderly population, heavier consumption exacerbates hypertension and increases the incidence of heart failure.
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Affiliation(s)
- Aditi Kalla
- Institute for Heart & Vascular Health, Division of Cardiology, Einstein Medical Center, Philadelphia, Pennsylvania
| | - Vincent M Figueredo
- Institute for Heart & Vascular Health, Division of Cardiology, Einstein Medical Center, Philadelphia, Pennsylvania.,Sidney Kimmel College of Medicine at Thomas Jefferson University, Philadelphia, Pennsylvania
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Larsson SC, Wallin A, Wolk A, Markus HS. Differing association of alcohol consumption with different stroke types: a systematic review and meta-analysis. BMC Med 2016; 14:178. [PMID: 27881167 PMCID: PMC5121939 DOI: 10.1186/s12916-016-0721-4] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whether light-to-moderate alcohol consumption is protective against stroke, and whether any association differs by stroke type, is controversial. We conducted a meta-analysis to summarize the evidence from prospective studies on alcohol drinking and stroke types. METHODS Studies were identified by searching PubMed to September 1, 2016, and reference lists of retrieved articles. Additional data from 73,587 Swedish adults in two prospective studies were included. Study-specific results were combined in a random-effects model. RESULTS The meta-analysis included 27 prospective studies with data on ischemic stroke (25 studies), intracerebral hemorrhage (11 studies), and/or subarachnoid hemorrhage (11 studies). Light and moderate alcohol consumption was associated with a lower risk of ischemic stroke, whereas high and heavy drinking was associated with an increased risk; the overall RRs were 0.90 (95 % CI, 0.85-0.95) for less than 1 drink/day, 0.92 (95 % CI, 0.87-0.97) for 1-2 drinks/day, 1.08 (95 % CI, 1.01-1.15) for more than 2-4 drinks/day, and 1.14 (95 % CI, 1.02-1.28) for more than 4 drinks/day. Light and moderate alcohol drinking was not associated with any hemorrhagic stroke subtype. High alcohol consumption (>2-4 drinks/day) was associated with a non-significant increased risk of both hemorrhagic stroke subtypes, and the relative risk for heavy drinking (>4 drinks/day) were 1.67 (95 % CI, 1.25-2.23) for intracerebral hemorrhage and 1.82 (95 % CI, 1.18-2.82) for subarachnoid hemorrhage. CONCLUSION Light and moderate alcohol consumption was inversely associated only with ischemic stroke, whereas heavy drinking was associated with increased risk of all stroke types with a stronger association for hemorrhagic strokes.
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Affiliation(s)
- Susanna C Larsson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden. .,Stroke Research Group, Neurology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK.
| | - Alice Wallin
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden
| | - Hugh S Markus
- Stroke Research Group, Neurology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
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de Gaetano G, Costanzo S, Di Castelnuovo A, Badimon L, Bejko D, Alkerwi A, Chiva-Blanch G, Estruch R, La Vecchia C, Panico S, Pounis G, Sofi F, Stranges S, Trevisan M, Ursini F, Cerletti C, Donati MB, Iacoviello L. Effects of moderate beer consumption on health and disease: A consensus document. Nutr Metab Cardiovasc Dis 2016; 26:443-467. [PMID: 27118108 DOI: 10.1016/j.numecd.2016.03.007] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/26/2016] [Accepted: 03/14/2016] [Indexed: 01/09/2023]
Abstract
A large evidence-based review on the effects of a moderate consumption of beer on human health has been conducted by an international panel of experts who reached a full consensus on the present document. Low-moderate (up to 1 drink per day in women, up to 2 in men), non-bingeing beer consumption, reduces the risk of cardiovascular disease. This effect is similar to that of wine, at comparable alcohol amounts. Epidemiological studies suggest that moderate consumption of either beer or wine may confer greater cardiovascular protection than spirits. Although specific data on beer are not conclusive, observational studies seem to indicate that low-moderate alcohol consumption is associated with a reduced risk of developing neurodegenerative disease. There is no evidence that beer drinking is different from other types of alcoholic beverages in respect to risk for some cancers. Evidence consistently suggests a J-shaped relationship between alcohol consumption (including beer) and all-cause mortality, with lower risk for moderate alcohol consumers than for abstainers or heavy drinkers. Unless they are at high risk for alcohol-related cancers or alcohol dependency, there is no reason to discourage healthy adults who are already regular light-moderate beer consumers from continuing. Consumption of beer, at any dosage, is not recommended for children, adolescents, pregnant women, individuals at risk to develop alcoholism, those with cardiomyopathy, cardiac arrhythmias, depression, liver and pancreatic diseases, or anyone engaged in actions that require concentration, skill or coordination. In conclusion, although heavy and excessive beer consumption exerts deleterious effects on the human body, with increased disease risks on many organs and is associated to significant social problems such as addiction, accidents, violence and crime, data reported in this document show evidence for no harm of moderate beer consumption for major chronic conditions and some benefit against cardiovascular disease.
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Affiliation(s)
- G de Gaetano
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy.
| | - S Costanzo
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy
| | - A Di Castelnuovo
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy
| | - L Badimon
- Cardiovascular Research Center (CSIC-ICCC), Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de Sant Pau, Barcelona, Spain
| | - D Bejko
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - A Alkerwi
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - G Chiva-Blanch
- Cardiovascular Research Center (CSIC-ICCC), Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de Sant Pau, Barcelona, Spain
| | - R Estruch
- Department of Internal Medicine, Hospital Clinic, University of Barcelona, Spain
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - S Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - G Pounis
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy
| | - F Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Don Carlo Gnocchi Foundation, ONLUS IRCCS, Florence, Italy
| | - S Stranges
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | | | - F Ursini
- Dipartimento di Medicina Molecolare, Università di Padova, Italy
| | - C Cerletti
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy
| | - M B Donati
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy
| | - L Iacoviello
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy
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Stevenson BS, Stephens C, Dulin P, Kostick M, Alpass F. Alcohol consumption among older adults in Aotearoa/New Zealand: a comparison of ‘baby boomers’ and ‘over-65s’. Health Psychol Behav Med 2015. [DOI: 10.1080/21642850.2015.1082916] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Jones SB, Loehr L, Avery CL, Gottesman RF, Wruck L, Shahar E, Rosamond WD. Midlife Alcohol Consumption and the Risk of Stroke in the Atherosclerosis Risk in Communities Study. Stroke 2015; 46:3124-30. [PMID: 26405203 PMCID: PMC4725192 DOI: 10.1161/strokeaha.115.010601] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/31/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE Alcohol consumption is common in the United States and may confer beneficial cardiovascular effects at light-to-moderate doses. The alcohol-stroke relationship remains debated. We estimated the relationship between midlife, self-reported alcohol consumption and ischemic stroke and intracerebral hemorrhage (ICH) in a biracial cohort. METHODS We examined 12,433 never and current drinkers in the Atherosclerosis Risk in Communities study, aged 45 to 64 years at baseline. Participants self-reported usual drinks per week of beer, wine, and liquor at baseline. We used multivariate Cox proportional hazards regression to assess the association of current alcohol consumption relative to lifetime abstention with incident ischemic stroke and ICH and modification by sex-race group. We modeled alcohol intake with quadratic splines to further assess dose-response relationships. RESULTS One third of participants self-reported abstention, 39% and 24%, respectively, consumed ≤3 and 4 to 17 drinks/wk, and only 5% reported heavier drinking. There were 773 ischemic strokes and 81 ICH over follow-up (median≈22.6 years). For ischemic stroke, light and moderate alcohol consumption were not associated with incidence (hazard ratios, 0.98; 95% CI, 0.79-1.21; 1.06, 0.84-1.34), whereas heavier drinking was associated with a 31% increased rate relative to abstention (hazard ratios, 1.31; 95% CI, 0.92-1.86). For ICH, moderate-to-heavy (hazard ratios, 1.99; 95% CI, 1.07-3.70), but not light, consumption increased incidence. CONCLUSIONS Self-reported light-to-moderate alcohol consumption at midlife was not associated with reduced stroke risk compared with abstention over 20 years of follow-up in the Atherosclerosis Risk in Communities study. Heavier consumption increased the risk for both outcomes as did moderate intake for ICH.
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Affiliation(s)
- Sara B Jones
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.).
| | - Laura Loehr
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.)
| | - Christy L Avery
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.)
| | - Rebecca F Gottesman
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.)
| | - Lisa Wruck
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.)
| | - Eyal Shahar
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.)
| | - Wayne D Rosamond
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.)
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Kadlecová P, Andel R, Mikulík R, Handing EP, Pedersen NL. Alcohol consumption at midlife and risk of stroke during 43 years of follow-up: cohort and twin analyses. Stroke 2015; 46:627-33. [PMID: 25634001 DOI: 10.1161/strokeaha.114.006724] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Although alcohol-stroke association is well known, the age-varying effect of alcohol drinking at midlife on subsequent stroke risk across older adulthood has not been examined. The effect of genetic/early-life factors is also unknown. We used cohort and twin analyses of data with 43 years of follow-up for stroke incidence to help address these gaps. METHODS All 11 644 members of the population-based Swedish Twin Registry born 1886 to 1925 with alcohol data aged ≤60 years were included. The interaction of midlife alcohol consumption by age at stroke was evaluated in Cox-regression and analyses of monozygotic twins were used. Covariates were baseline age, sex, cardiovascular diseases, diabetes mellitus, stress reactivity, depression, body mass index, smoking, and exercise. RESULTS Altogether 29% participants developed stroke. Compared with very-light drinkers (<0.5 drink/d), heavy drinkers (>2 drinks/d) had greater risk of stroke (hazard ratio, 1.34; P=0.02) and the effect for nondrinkers approached significance (hazard ratio, 1.11; P=0.08). Age increased stroke risk for nondrinkers (P=0.012) and decreased it for heavy drinkers (P=0.040). Midlife heavy drinkers were at high risk from baseline until the age of 75 years when hypertension and diabetes mellitus grew to being the more relevant risk factors. In analyses of monozygotic twin-pairs, heavy drinking shortened time to stroke by 5 years (P=0.04). CONCLUSIONS Stroke-risk associated with heavy drinking (>2 drinks/d) in midlife seems to predominate over well-known risk factors, hypertension and diabetes, until the age of ≈75 years and may shorten time to stroke by 5 years above and beyond covariates and genetic/early-life factors. Alcohol consumption should be considered an age-varying risk factor for stroke.
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Affiliation(s)
- Pavla Kadlecová
- From the International Clinical Research Center, Neurology Department, St. Anne's Hospital, Brno, Czech Republic (P.K., R.A., R.M.); School of Aging Studies, University of South Florida, Tampa (R.A., E.P.H.); Department of Neurology, St. Anne's University Hospital and Medical Faculty of Masaryk University, Brno, Czech Republic (R.M.); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (N.L.P.); and Department of Psychology, University of Southern California, Los Angeles (N.L.P.).
| | - Ross Andel
- From the International Clinical Research Center, Neurology Department, St. Anne's Hospital, Brno, Czech Republic (P.K., R.A., R.M.); School of Aging Studies, University of South Florida, Tampa (R.A., E.P.H.); Department of Neurology, St. Anne's University Hospital and Medical Faculty of Masaryk University, Brno, Czech Republic (R.M.); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (N.L.P.); and Department of Psychology, University of Southern California, Los Angeles (N.L.P.)
| | - Robert Mikulík
- From the International Clinical Research Center, Neurology Department, St. Anne's Hospital, Brno, Czech Republic (P.K., R.A., R.M.); School of Aging Studies, University of South Florida, Tampa (R.A., E.P.H.); Department of Neurology, St. Anne's University Hospital and Medical Faculty of Masaryk University, Brno, Czech Republic (R.M.); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (N.L.P.); and Department of Psychology, University of Southern California, Los Angeles (N.L.P.)
| | - Elizabeth P Handing
- From the International Clinical Research Center, Neurology Department, St. Anne's Hospital, Brno, Czech Republic (P.K., R.A., R.M.); School of Aging Studies, University of South Florida, Tampa (R.A., E.P.H.); Department of Neurology, St. Anne's University Hospital and Medical Faculty of Masaryk University, Brno, Czech Republic (R.M.); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (N.L.P.); and Department of Psychology, University of Southern California, Los Angeles (N.L.P.)
| | - Nancy L Pedersen
- From the International Clinical Research Center, Neurology Department, St. Anne's Hospital, Brno, Czech Republic (P.K., R.A., R.M.); School of Aging Studies, University of South Florida, Tampa (R.A., E.P.H.); Department of Neurology, St. Anne's University Hospital and Medical Faculty of Masaryk University, Brno, Czech Republic (R.M.); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (N.L.P.); and Department of Psychology, University of Southern California, Los Angeles (N.L.P.)
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Choi NG, Kim J, Marti CN, Chen GJ. Late-life depression and cardiovascular disease burden: examination of reciprocal relationship. Am J Geriatr Psychiatry 2014; 22:1522-9. [PMID: 24856874 PMCID: PMC4351713 DOI: 10.1016/j.jagp.2014.04.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/10/2014] [Accepted: 04/11/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Empirical studies of the relationship between depression and cardiovascular disease (CVD) tend to be limited to examination of one-way relationships. This study assessed both cross-sectional association and longitudinal reciprocal relationships between late-life depressive symptoms and CVD. METHODS The National Health and Aging Trends Study waves 1 (T1) and 2 (T2, one year later) provided the data. The study sample (N = 5,414) represented Medicare beneficiaries aged 65 years or older. We fit structural equation models to examine: 1) cross-sectional association between depression and CVD at each wave; and 2) longitudinal reciprocal relationship between T1 depression and T2 CVD and between T1 CVD and T2 depression. RESULTS At T1, 28.6% reported a CVD diagnosis, and at T2, 4.9% reported having had a new diagnosis or new episode of heart attack or heart disease and 2.2% reported having had a stroke since T1. In addition to significant cross-sectional relationships between depression and CVD, T1 CVD had significant impact on T2 depressive symptoms, and T1 depressive symptoms had significant impact on T2 CVD, with a 1-point increase in depressive symptom score increasing the odds of having a new CVD diagnosis or episode by 21%. CONCLUSIONS The care of older adults with CVD and/or depression needs to include interventions focusing on lifestyle and psychological factors that can reduce risks for both CVD and depression. Depression prevention and treatment also needs to be an integral part of CVD prevention and management.
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Affiliation(s)
- Namkee G Choi
- School of Social Work, University of Texas at Austin, Austin, TX.
| | - Jinseok Kim
- Department of Social Welfare, Seoul Women's University, Seoul, Korea
| | - C Nathan Marti
- Division of Statistics and Scientific Computation, College of Natural Sciences, University of Texas at Austin, Austin, TX
| | - G John Chen
- Division of Health Services Research, Department of Internal Medicine, the University of Kansas Medical Center, Kansas City, KS
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Yang JY, Xue X, Tian H, Wang XX, Dong YX, Wang F, Zhao YN, Yao XC, Cui W, Wu CF. Role of microglia in ethanol-induced neurodegenerative disease: Pathological and behavioral dysfunction at different developmental stages. Pharmacol Ther 2014; 144:321-37. [DOI: 10.1016/j.pharmthera.2014.07.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 07/03/2014] [Indexed: 01/04/2023]
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Alcohol intake and risk of stroke: A dose–response meta-analysis of prospective studies. Int J Cardiol 2014; 174:669-77. [DOI: 10.1016/j.ijcard.2014.04.225] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 04/15/2014] [Accepted: 04/18/2014] [Indexed: 11/19/2022]
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A conceptual model to facilitate transitions from primary care to specialty substance use disorder care: a review of the literature. Prim Health Care Res Dev 2014; 16:492-505. [PMID: 24818752 DOI: 10.1017/s1463423614000164] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIM This article presents a conceptual model to help facilitate the transition from primary care to specialty substance use disorder (SUD) care for appropriate patients. BACKGROUND Substance misuse is a common health condition among patients presenting to primary care settings and may complicate the treatment of chronic health conditions such as diabetes and hypertension. It is therefore critical that primary care providers be prepared to identify and determine appropriate treatment options for patients presenting with substance misuse. METHODS We conducted a narrative review that occurred in three stages: literature review of health care transition models, identification of conceptual domains common across care transition models, and identification of SUD-specific model elements. Findings The conceptual model presented describes patient, provider, and system-level facilitators and barriers to the transition process, and includes intervention strategies that can be utilized by primary care clinics to potentially improve the process of transitioning patients from primary care to SUD care. Recognizing that primary care clinics vary in available resources, we present three examples of care practices along an intensity continuum from low (counseling and referral) to moderate (telephone monitoring) to high (intensive case management) resource demands for adoption. We also provide a list of common outcomes clinics might consider when evaluating the impact of care transition practices in this patient population; these include process outcomes such as patients' increased knowledge of available treatment resources, and health outcomes such as patients' reduced substance use and better quality of life.
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Yoo TK, Oh E, Hong S. Is vitamin D status associated with open-angle glaucoma? A cross-sectional study from South Korea. Public Health Nutr 2014; 17:833-43. [PMID: 24476947 PMCID: PMC10282225 DOI: 10.1017/s1368980013003492] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 10/13/2013] [Accepted: 11/18/2013] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Open-angle glaucoma (OAG) is one of the major chronic diseases involving the optic nerve. However, little is known about the association between vitamin D and OAG. The present study was conducted to test the hypothesis that lower vitamin D status is associated with greater prevalence of OAG. DESIGN Cross-sectional study. Multivariable logistic regression was performed to examine the relationship between serum 25-hydroxyvitamin D (25(OH)D) and OAG after adjusting for traditional potential confounders. OAG was defined by the criteria of the International Society for Geographical and Epidemiological Ophthalmology. SETTING The Fifth Korean National Health and Nutrition Examination Survey conducted in 2010-2011. SUBJECTS Six thousand and ninety-four adult participants randomly selected from 192 surveys in 131 locations in South Korea. RESULTS Multivariable-adjusted odds ratios of OAG across quintiles of decreasing 25(OH)D were 1.26, 1.00 (reference), 1.31, 1.36 and 1.69 (P for quadratic trend <0.01). The odds ratio for the lowest 25(OH)D quintile was significantly higher than that for the second quintile (P < 0.01). In addition, we discovered that the predictors for worsening of OAG, such as intraocular pressure or vertical and horizontal cup-to-disc ratios, had a significant relationship with 25(OH)D level. CONCLUSIONS There was a reverse J-shaped association between 25(OH)D levels and the risk of OAG, with significantly elevated risk at lower 25(OH)D. The findings of this research suggest that vitamin D deficiency should be considered as a potential risk factor for the development of OAG. To our knowledge, the present study is the first one that shows an association between vitamin D status and OAG.
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Affiliation(s)
- Tae Keun Yoo
- Department of Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ein Oh
- Department of Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
| | - Samin Hong
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea
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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: 238] [Impact Index Per Article: 23.8] [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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Seawell AH, Toussaint LL, Cheadle ACD. Prospective associations between unforgiveness and physical health and positive mediating mechanisms in a nationally representative sample of older adults. Psychol Health 2013; 29:375-89. [PMID: 24266673 DOI: 10.1080/08870446.2013.856434] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study examined the prospective association between unforgiveness and self-reported physical health and potential positive psychological mediators of this association. DESIGN Participants were a national sample of 1024 USA's adults of ages 66 years and older. Data were collected at two time points separated by three years. MAIN OUTCOME MEASURES Measures of trait unforgiveness, self-rated physical health, socio-demographics, health behaviours and positive psychological traits (e.g. life satisfaction, self-esteem) were included in a comprehensive survey known as the 'Religion, Aging, and Health Survey.' RESULTS The results indicated that unforgiveness was prospectively associated with declines in self-reported physical health three years later, and poor initial self-reported health status did not predict increases in unforgiveness across time. Furthermore, the prospective association of unforgiveness with self-reported health was mediated by a latent positive psychological traits variable. CONCLUSION These results confirm cross-sectional findings suggesting that unforgiveness is related to health. The present study also suggests that unforgiveness has a prospective, but not reciprocal, association with self-reported physical health. Unforgiveness may have its association with self-reported physical health through its interruption of other positive traits that typically confer health benefits.
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Affiliation(s)
- Asani H Seawell
- a Department of Psychology , Grinnell College , Grinnell , IA , USA
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Levantesi G, Marfisi R, Mozaffarian D, Franzosi MG, Maggioni A, Nicolosi GL, Schweiger C, Silletta M, Tavazzi L, Tognoni G, Marchioli R. Wine consumption and risk of cardiovascular events after myocardial infarction: Results from the GISSI-Prevenzione trial. Int J Cardiol 2013; 163:282-287. [DOI: 10.1016/j.ijcard.2011.06.053] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 04/24/2011] [Accepted: 06/06/2011] [Indexed: 10/18/2022]
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Massaro M, Scoditti E, Carluccio MA, De Caterina R. Alcohol and atherosclerosis: A double edged sword. Vascul Pharmacol 2012; 57:65-8. [DOI: 10.1016/j.vph.2012.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 05/26/2012] [Indexed: 10/28/2022]
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Abstract
BACKGROUND Alcohol use disorders are associated with other mental health disorders in young adults, but there are few data on alcohol use and mental health outcomes in older adults, particularly the oldest old. This study examines the relationship between alcohol consumption and depressive symptoms. METHODS Data were collected from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project, which has pooled nine Australian longitudinal studies. Alcohol consumption was classified using standard drinks (10 g alcohol)/day as: abstinent, low risk (<0-≤ 2 standard drinks), long-term risk (>2-≤ 4) and short-term risk (>4). Probable depression was classified from harmonized scores on various standard instruments (e.g. Centre for Epidemiological Studies Depression scale). RESULTS Overall, 39,104 (86%) participants contributed data. Alcohol classification at baseline showed 7,526 abstinent, 28,112 low risk, 2,271 long-term risk, and 1,195 short-term risk participants. Age ranged from 45 to 103 year (median 60). Using generalized estimating equations (GEE), there were significant gender by alcohol and gender by age interactions, so the analysis was split by gender. Among males, the abstinent and short-term risk groups had increased likelihood of depression: in females the abstinent, long- and short-term risk groups had increased odds of depression. Increased odds of depression was also associated with former and current smoking, younger age-group, not being partnered, leaving school before age 15 and increasing levels of health-impaired walking, dressing, or bathing. CONCLUSION The impact of alcohol use differs by gender, nevertheless those using higher levels of alcohol or who smoke should be screened for depression and may benefit from interventions.
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Shi X, Yao D, Chen C. Identification of N-acetyltaurine as a novel metabolite of ethanol through metabolomics-guided biochemical analysis. J Biol Chem 2012; 287:6336-49. [PMID: 22228769 DOI: 10.1074/jbc.m111.312199] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The influence of ethanol on the small molecule metabolome and the role of CYP2E1 in ethanol-induced hepatotoxicity were investigated using liquid chromatography-mass spectrometry (LC-MS)-based metabolomics platform and Cyp2e1-null mouse model. Histological and biochemical examinations of ethanol-exposed mice indicated that the Cyp2e1-null mice were more resistant to ethanol-induced hepatic steatosis and transaminase leakage than the wild-type mice, suggesting CYP2E1 contributes to ethanol-induced toxicity. Metabolomic analysis of urinary metabolites revealed time- and dose-dependent changes in the chemical composition of urine. Along with ethyl glucuronide and ethyl sulfate, N-acetyltaurine (NAT) was identified as a urinary metabolite that is highly responsive to ethanol exposure and is correlated with the presence of CYP2E1. Subsequent stable isotope labeling analysis using deuterated ethanol determined that NAT is a novel metabolite of ethanol. Among three possible substrates of NAT biosynthesis (taurine, acetyl-CoA, and acetate), the level of taurine was significantly reduced, whereas the levels of acetyl-CoA and acetate were dramatically increased after ethanol exposure. In vitro incubation assays suggested that acetate is the main precursor of NAT, which was further confirmed by the stable isotope labeling analysis using deuterated acetate. The incubations of tissues and cellular fractions with taurine and acetate indicated that the kidney has the highest NAT synthase activity among the tested organs, whereas the cytosol is the main site of NAT biosynthesis inside the cell. Overall, the combination of biochemical and metabolomic analysis revealed NAT is a novel metabolite of ethanol and a potential biomarker of hyperacetatemia.
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Affiliation(s)
- Xiaolei Shi
- Department of Food Science and Nutrition, University of Minnesota, St Paul, Minnesota 55108, USA
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Carrieri MP, Protopopescu C, Le Moing V, Reboud P, Raffi F, Mahy S, Roux P, Cuzin L, Spire B, Leport C. Impact of immunodepression and moderate alcohol consumption on coronary and other arterial disease events in an 11-year cohort of HIV-infected patients on antiretroviral therapy. BMJ Open 2012; 2:e001155. [PMID: 23180454 PMCID: PMC3533116 DOI: 10.1136/bmjopen-2012-001155] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To investigate the relationship between response to antiretroviral therapy (ART), alcohol use and occurrence of a major coronary or other arterial disease event (CADE) in HIV-infected individuals. DESIGN A cohort study. A Cox model was used to identify the correlates of a first occurrence of a major CADE. SETTING The French ANRS CO8 APROCO-COPILOTE cohort was set up in 1997 to study clinical progression and patient-reported outcomes (PRO) after initiating a protease inhibitor-containing ART. Clinical data were retrieved from medical records. Self-administered questionnaires collected data on PRO and behaviours, including alcohol use. PARTICIPANTS Metabolic data were only available for a subgroup (n=675) of the study group (n=1154). MAIN OUTCOME MEASURES Major coronary or other arterial disease first event. RESULTS Over the 11-year follow-up, 49 major CADE were observed, with an incidence rate (95% CI)=0.75(0.57 to 0.99) per 100 person-years. Immunodepression (CD4 cell count <200 cells/mm(3)) was associated with an increased risk of CADE (adjusted HR (95% CI)=2.52(1.15 to 5.48)) after adjustment for female gender (0.25(0.08 to 0.83)), age (1.07(1.04 to 1.10)) and smoking>20 cigarettes/day (4.19(2.17 to 8.11)). Moreover, individuals with moderate alcohol consumption (≤4(3) alcohol units (AU)/day for men(women)) had a lower risk of CADE (0.38(0.20 to 0.71)) than alcohol abstainers, although the risk for those drinking>4(3) AU/day for men(women) was not significantly different from this latter group. These associations remained valid after adjustment for metabolic disorders. No significant association with exposure to any specific antiretroviral was detected. CONCLUSIONS In the long term, absence of immunodepression and moderate alcohol consumption remain associated with a lower risk of a major CADE. Combined interventions to reduce CADE-risk-related behaviours including adherence counselling for assuring long-term immunological response to ART in HIV-infected individuals are now a clinical and public health priority.
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Affiliation(s)
- Maria Patrizia Carrieri
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- Aix Marseille Université, UMR_S912, IRD, 13006, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur 13006, Marseille, France
| | - Camelia Protopopescu
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- Aix Marseille Université, UMR_S912, IRD, 13006, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur 13006, Marseille, France
| | - Vincent Le Moing
- Service de Maladies Infectieuses et Tropicales, CHU de Montpellier, UMI 233 TransVIHMI, IRD, Université 34295, Montpellier 1, Montpellier, France
| | - Philippe Reboud
- INSERM, U897, Université Bordeaux Segalen, ISPED, 33076, Bordeaux, France
| | - François Raffi
- Service de Maladies Infectieuses et Tropicales, CHU Hôtel-Dieu, 44093, Nantes, France
| | - Sophie Mahy
- CHU de Dijon, Université de Bourgogne, 21000, Dijon, France
| | - Perrine Roux
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- Substance Use Research Center, NYSPI, Columbia University, 10032, New York, USA
| | - Lise Cuzin
- Service de Maladies Infectieuses et Tropicales, CHU Purpan, 31059, Toulouse, France
| | - Bruno Spire
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- Aix Marseille Université, UMR_S912, IRD, 13006, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur 13006, Marseille, France
| | - Catherine Leport
- Université Paris Diderot, Sorbonne Paris Cité, UMR 738, Paris, France
- INSERM, UMR 738, 75018, Paris, 75018, France
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McFarland MJ, Smith CA, Toussaint L, Thomas PA. Forgiveness of others and health: do race and neighborhood matter? J Gerontol B Psychol Sci Soc Sci 2012; 67:66-75. [PMID: 22156629 PMCID: PMC3267023 DOI: 10.1093/geronb/gbr121] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 09/27/2011] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study examines the relationship between interpersonal forgiveness and health for older Blacks and Whites. We outline a series of arguments concerning the following: (a) how forgiveness can affect health, (b) how forgiveness may be more protective for Blacks, and (c) how the relationship between forgiveness and health may vary by neighborhood deterioration. METHOD Two waves (2001 and 2004) of the Religion, Aging, and Health Survey provided data from a nationally representative elderly sample of 436 Blacks and 500 Whites. Measures included sociodemographics, forgiveness, and three dimensions of health: self-reported health, alcohol use, and chronic conditions. We employ both longitudinal and cross-sectional analyses. RESULTS Results suggest that forgiveness of others was protective of health for Blacks but not Whites. Moreover, among Blacks, we found the following: (a) forgiveness was positively associated with self-reported health over time, (b) forgiveness was negatively associated with alcohol use and number of chronic conditions, and (c) forgiveness interacted with neighborhood deterioration such that the beneficial effects of forgiveness for self-reported health did not extend to those living in run-down neighborhoods. DISCUSSION Race and neighborhood were shown to be important for understanding the forgiveness-health connection. Forgiveness was associated with better health for Blacks but not Whites, consistent with McCullough's evolutionary framework (McCullough, M. E. (2008). Beyond revenge: The evolution of the forgiveness instinct. San Francisco, CA: Jossey-Bass), forgiveness was beneficial in some settings but had a deleterious impact in more noxious environments. This study suggests that researchers should give more consideration to race and social context in attempting to more fully understand the relationship between forgiveness and health.
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The stroke offspring study: is parental stroke history of value in targeted risk factor screening? Prim Health Care Res Dev 2011; 12:21-8. [PMID: 21426612 DOI: 10.1017/s1463423610000186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIM This study aimed to compare the prevalence of stroke risk factors among people with a parental history of stroke to those in a control group of individuals, of similar age, gender and social class, with no parental stroke history. BACKGROUND Parental stroke increases an individual's risk of stroke, but little is known of the potential value of using this information in targeted screening for primary prevention in general practice. METHOD We sent questionnaires to 300 randomly selected individuals aged 40-65 years, in each of 11 different general practices in Northern Ireland. Among 1061 responses received within six weeks, 332 reported a parental history of stroke (31.3%). We matched respondents with (cases) and without (controls) a parental history of stroke on characteristics of age, gender and socioeconomic status. Matched pairs were invited to attend a consultation at which their diet and exercise habits were assessed using validated questionnaires and height, weight, blood pressure and serum lipids and glucose were measured. FINDINGS Matched data were available for 199 case-control pairs (398 individuals). Mean systolic and diastolic blood pressures were significantly higher in cases than in paired controls (systolic 146.3 versus 140.6 mmHg (P < 0.01); diastolic 87.7 versus 85.0 mmHg (P = 0.014)). Cases consumed more alcohol than their paired controls (13.8 versus 10.1 U/week (P < 0.01)), but their measures of body mass index, lipids, diabetes, diet and exercise did not differ significantly. The results of this study suggest that screening offspring of patients with stroke in respect of blood pressure has potential value in identifying people likely to benefit from primary prevention, but do not support the adoption of a targeted screening strategy for other commonly cited stroke risk factors.
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Strat YL, Gorwood P. Hazardous Drinking Is Associated with a Lower Risk of Coronary Heart Disease: Results from a National Representative Sample. Am J Addict 2011; 20:257-63. [DOI: 10.1111/j.1521-0391.2011.00125.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ 2011; 342:d671. [PMID: 21343207 PMCID: PMC3043109 DOI: 10.1136/bmj.d671] [Citation(s) in RCA: 1043] [Impact Index Per Article: 80.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To conduct a comprehensive systematic review and meta-analysis of studies assessing the effect of alcohol consumption on multiple cardiovascular outcomes. DESIGN Systematic review and meta-analysis. DATA SOURCES A search of Medline (1950 through September 2009) and Embase (1980 through September 2009) supplemented by manual searches of bibliographies and conference proceedings. Inclusion criteria Prospective cohort studies on the association between alcohol consumption and overall mortality from cardiovascular disease, incidence of and mortality from coronary heart disease, and incidence of and mortality from stroke. Studies reviewed Of 4235 studies reviewed for eligibility, quality, and data extraction, 84 were included in the final analysis. RESULTS The pooled adjusted relative risks for alcohol drinkers relative to non-drinkers in random effects models for the outcomes of interest were 0.75 (95% confidence interval 0.70 to 0.80) for cardiovascular disease mortality (21 studies), 0.71 (0.66 to 0.77) for incident coronary heart disease (29 studies), 0.75 (0.68 to 0.81) for coronary heart disease mortality (31 studies), 0.98 (0.91 to 1.06) for incident stroke (17 studies), and 1.06 (0.91 to 1.23) for stroke mortality (10 studies). Dose-response analysis revealed that the lowest risk of coronary heart disease mortality occurred with 1-2 drinks a day, but for stroke mortality it occurred with ≤1 drink per day. Secondary analysis of mortality from all causes showed lower risk for drinkers compared with non-drinkers (relative risk 0.87 (0.83 to 0.92)). CONCLUSIONS Light to moderate alcohol consumption is associated with a reduced risk of multiple cardiovascular outcomes.
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Affiliation(s)
- Paul E Ronksley
- Department of Community Health Sciences, Faculty of Medicine, Calgary Institute for Population and Public Health, University of Calgary, Alberta, Canada
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Epidemiology of ischaemic stroke and traumatic brain injury. Best Pract Res Clin Anaesthesiol 2010; 24:485-94. [DOI: 10.1016/j.bpa.2010.10.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 10/11/2010] [Indexed: 11/23/2022]
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Patra J, Taylor B, Irving H, Roerecke M, Baliunas D, Mohapatra S, Rehm J. Alcohol consumption and the risk of morbidity and mortality for different stroke types--a systematic review and meta-analysis. BMC Public Health 2010; 10:258. [PMID: 20482788 PMCID: PMC2888740 DOI: 10.1186/1471-2458-10-258] [Citation(s) in RCA: 251] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Accepted: 05/18/2010] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Observational studies have suggested a complex relationship between alcohol consumption and stroke, dependent on sex, type of stroke and outcome (morbidity vs. mortality). We undertook a systematic review and a meta-analysis of studies assessing the association between levels of average alcohol consumption and relative risks of ischemic and hemorrhagic strokes separately by sex and outcome. This meta-analysis is the first to explicitly separate morbidity and mortality of alcohol-attributable stroke and thus has implications for public health and prevention. METHODS Using Medical Subject Headings (alcohol drinking, ethanol, cerebrovascular accident, cerebrovascular disorders, and intracranial embolism and thrombosis and the key word stroke), a literature search of MEDLINE, EMBASE, CINAHL, CABS, WHOlist, SIGLE, ETOH, and Web of Science databases between 1980 to June 2009 was performed followed by manual searches of bibliographies of key retrieved articles. From twenty-six observational studies (cohort or case-control) with ischemic or hemorrhagic strokes the relative risk or odds ratios or hazard ratios of stroke associated with alcohol consumption were reported; alcohol consumption was quantified; and life time abstention (manually estimated where data for current abstainers were given) was used as the reference group. Two reviewers independently extracted the information on study design, participant characteristics, level of alcohol consumption, stroke outcome, control for potential confounding factors, risk estimates and key criteria of study quality using a standardized protocol. RESULTS The dose-response relationship for hemorrhagic stroke had monotonically increasing risk for increasing consumption, whereas ischemic stroke showed a curvilinear relationship, with a protective effect of alcohol for low to moderate consumption, and increased risk for higher exposure. For more than 3 drinks on average/day, in general women had higher risks than men, and the risks for mortality were higher compared to the risks for morbidity. CONCLUSIONS These results indicate that heavy alcohol consumption increases the relative risk of any stroke while light or moderate alcohol consumption may be protective against ischemic stroke. Preventive measures that should be initiated are discussed.
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Affiliation(s)
- Jayadeep Patra
- Centre for Addiction and Mental Health, Toronto, Ontario Canada.
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Alcohol consumption and cardiovascular mortality among U.S. adults, 1987 to 2002. J Am Coll Cardiol 2010; 55:1328-35. [PMID: 20338493 DOI: 10.1016/j.jacc.2009.10.056] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Revised: 09/16/2009] [Accepted: 10/14/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of this study was to determine the association of alcohol consumption and cardiovascular mortality in the U.S. population. BACKGROUND Alcohol consumption has been associated with a lower risk of cardiovascular disease in cohort studies, but this association has not been prospectively examined in large, detailed, representative samples of the U.S. population. METHODS We analyzed 9 iterations of the National Health Interview Survey, an annual survey of a nationally representative sample of U.S. adults between 1987 and 2000. Exposures of interest included usual volume, frequency, and quantity of alcohol consumption and binge drinking. Mortality was ascertained through linkage to the National Death Index through 2002. Relative risks were derived from random-effects meta-analyses of weighted, multivariable-adjusted hazard ratios for cardiovascular mortality from individual survey administrations. RESULTS Light and moderate volumes of alcohol consumption were inversely associated with cardiovascular mortality. Compared with lifetime abstainers, summary relative risks were 0.95 (95% confidence interval [CI]: 0.88 to 1.02) among lifetime infrequent drinkers, 1.02 (95% CI: 0.94 to 1.11) among former drinkers, 0.69 (95% CI: 0.59 to 0.82) among light drinkers, 0.62 (95% CI: 0.50 to 0.77) among moderate drinkers, and 0.95 (95% CI: 0.82 to 1.10) among heavy drinkers. The magnitude of lower risk was similar in subgroups of sex, age, or baseline health status. There was no simple relation of drinking pattern with risk, but risk was consistently higher among those who consumed >or=3 compared with 2 drinks/drinking day. CONCLUSIONS In 9 nationally representative samples of U.S. adults, light and moderate alcohol consumption were inversely associated with CVD mortality, even when compared with lifetime abstainers, but consumption above recommended limits was not.
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Menon V, Katz R, Mukamal K, Kestenbaum B, de Boer IH, Siscovick DS, Sarnak MJ, Shlipak MG. Alcohol consumption and kidney function decline in the elderly: alcohol and kidney disease. Nephrol Dial Transplant 2010; 25:3301-7. [PMID: 20400446 DOI: 10.1093/ndt/gfq188] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Alcohol consumption appears to be protective for cardiovascular disease; however, its relationship with kidney disease is unclear. METHODS This prospective cohort study included 4343 subjects from the Cardiovascular Health Study, a longitudinal, community-based cohort of persons aged ≥65 from four US communities. We used previously defined categories based on weekly alcohol consumption: none, former, <1 drink, 1-6 drinks, 7-13 drinks and ≥14 drinks. Cystatin C was measured at baseline, year 3 and year 7; eligible subjects had at least two measures. Estimated GFR(cys) was calculated from cystatin C. The primary outcome was rapid kidney function as an annual estimated GFR (eGFR(cys)) loss >3 mL/min/1.73 m(2)/year. RESULTS Eight percent of the cohort reported former alcohol use and 52% reported current alcohol consumption. During a mean follow-up of 5.6 years, 1075 (25%) participants had rapid kidney function decline. In adjusted logistic regression models, there was no association between alcohol use and kidney function decline (odds ratio, 95% confidence interval: none = reference; former = 1.18, 0.89-1.56; <1 drink = 1.20, 0.99-1.47; 1-6 = 1.18, 0.95-1.45; 7-13 = 1.10, 0.80-1.53; >14 = 0.89, 0.61-1.13). Results were similar with kidney function decline as a continuous outcome. CONCLUSIONS Our results suggest that moderate alcohol consumption has neither adverse nor beneficial effects on kidney function. Although clinicians will need to consider the potential deleterious effects associated with alcohol consumption, there does not appear to be a basis for recommending that older adults discontinue or initiate light to moderate alcohol consumption to protect against kidney disease.
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Affiliation(s)
- Vandana Menon
- Division of Nephrology, Tufts Medical Center, Boston, MA, USA.
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Ethanol and cognition: indirect effects, neurotoxicity and neuroprotection: a review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2010; 7:1540-57. [PMID: 20617045 PMCID: PMC2872345 DOI: 10.3390/ijerph7041540] [Citation(s) in RCA: 160] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2010] [Accepted: 04/01/2010] [Indexed: 01/03/2023]
Abstract
Ethanol affects cognition in a number of ways. Indirect effects include intoxication, withdrawal, brain trauma, central nervous system infection, hypoglycemia, hepatic failure, and Marchiafava-Bignami disease. Nutritional deficiency can cause pellagra and Wernicke-Korsakoff disorder. Additionally, ethanol is a direct neurotoxin and in sufficient dosage can cause lasting dementia. However, ethanol also has neuroprotectant properties and in low-to-moderate dosage reduces the risk of dementia, including Alzheimer type. In fetuses ethanol is teratogenic, and whether there exists a safe dose during pregnancy is uncertain and controversial.
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