Putting the glass down may keep the stroke away: Results from a prospective cohort study in rural China

Abstract Background and Aims Most studies assess the relationship between alcohol and stroke at some point. Little is known about the effect on stroke of drinking status changes over time. This study aimed to examine the association of median 2.4-year drinking status changes with risk of stroke. Methods and Results We examined 22691 adults from rural China. Drinking status was assessed at 2004-2006 and in 2008. Participants were divided into four change patterns: consistent non-drinkers, abstainers, starters, and consistent drinkers. A Cox proportional hazards model were performed. We observed 1215 cases of stroke during a median follow-up period of 11.8 years. A faint J-shaped association between alcohol consumption and risk of stroke was found in this population. Based on the amount of alcohol consumption, only current drinkers with ≥721 g/week at baseline in both males and females had a higher risk of stroke [hazard ratio (HR): 1.342; 95% confidence interval (CI): 1.070–1.683 and HR: 2.130; CI: 1.041–4.357, respectively]. Based on change patterns, Compared with consistent non-drinkers, the HR (95% CI) for consistent drinkers, abstainers and starters was 1.298 (1.070–1.576), 1.093 (0.877–1.362) and 1.263 (1.034–1.543), respectively. The same trend was observed in male. The HR (95% CI) for consistent drinkers, abstainers and starters was 1.360 (1.098–1.685), 1.139 (0.883–1.470) and 1.364 (1.092–1.703), respectively. No difference was observed in females. Conclusion High alcohol consumption was associated with increased risk of stroke in both males and females. However, based on change patterns, consistent drinkers and starters were at higher risk of stroke only in males.