Alcohol Consumption and Risk of Stroke

Reynolds, Kristi; Lewis, L. Brian; Nolen, John David L.; Kinney, Gregory L.; Sathya, Bhavani; He, Jiang

doi:10.1001/jama.289.5.579

Cited by 802 publications

(566 citation statements)

References 77 publications

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“…This [EtOH] falls within the range obtained in circulation during moderate-heavy alcohol intake and of alcoholic patients with stroke-like episodes (4,27,28). In contrast to the EtOH effect, application of PSS containing either dextrose or urea (50 mM) consistently failed to evoke constriction [diameter: 105.8 Ϯ 2.2% of controls (n ϭ 4) and 98.4 Ϯ 0.7% of controls (n ϭ 4)].…”

Section: Alcohol Constricts Pressurized Cerebral Arteries By a Directsupporting

confidence: 65%

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Essential role for smooth muscle BK channels in alcohol-induced cerebrovascular constriction

Liu

Xi²,

Ahmed³

et al. 2004

Proc. Natl. Acad. Sci. U.S.A.

171

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Binge drinking is associated with increased risk for cerebrovascular spasm and stroke. Acute exposure to ethanol at concentrations obtained during binge drinking constricts cerebral arteries in several species, including humans, but the mechanisms underlying this action are largely unknown. In a rodent model, we used fluorescence microscopy, patch-clamp electrophysiology, and pharmacological studies in intact cerebral arteries to pinpoint the molecular effectors of ethanol cerebrovascular constriction. Clinically relevant concentrations of ethanol elevated wall intracellular Ca 2؉ concentration and caused a reversible constriction of cerebral arteries (EC50 ‫؍‬ 27 mM; Emax ‫؍‬ 100 mM) that depended on voltage-gated Ca 2؉ entry into myocytes. However, ethanol did not directly increase voltage-dependent Ca 2؉ currents in isolated myocytes. Constriction occurred because of an ethanol reduction in the frequency (؊53%) and amplitude (؊32%) of transient Ca 2؉ -activated K ؉ (BK) currents. Ethanol inhibition of BK transients was caused by a reduction in Ca 2؉ spark frequency (؊49%), a subsarcolemmal Ca 2؉ signal that evokes the BK transients, and a direct inhibition of BK channel steady-state activity (؊44%). In contrast, ethanol failed to modify Ca 2؉ waves, a major vasoconstrictor mechanism. Selective block of BK channels largely prevented ethanol constriction in pressurized arteries. This study pinpoints the Ca 2؉ spark͞BK channel negative-feedback mechanism as the primary effector of ethanol vasoconstriction.M oderate-heavy episodic alcohol intake, such as in binge drinking, remains a major public health problem (1, 2). Moderate-heavy drinking is associated, independently of any other factor, with an increased risk for stroke and deaths from ischemic stroke (3, 4). Binge drinkers are significantly predisposed to brain hemorrhage, cerebrovascular spasm, and stroke (3, 5).Cerebrovascular disease associated with moderate-heavy alcohol intake is independent of beverage type and alcohol metabolism but linked to ethanol (EtOH) itself (6, 7). Strong evidence for a dose-response relationship between EtOH intake and risk for stroke suggests causality (8). EtOH cerebral artery constriction is considered responsible for cerebral vasospasm, ischemia, and stroke in moderate-heavy drinkers (6, 9). Acute EtOH at legally intoxicating (Ն20 mM) blood levels in naive subjects constricts cerebral arteries in several species, including humans (7, 9).Rats are excellent models to study EtOH cerebral artery constriction and stroke (7,10,11). Evidence from this and other species indicates that EtOH constricts cerebral arteries by acting primarily on the smooth muscle (7,11,12). However, the molecular mechanisms mediating EtOH cerebral artery constriction remain largely unidentified.In cerebrovascular smooth muscle, an elevation in global intracellular Ca 2ϩ ([Ca 2ϩ ] ic ) leads to contraction (13). Ca 2ϩ mobilization in response to EtOH may result from direct potentiation of mechanisms leading to Ca 2ϩ influx͞release from internal organel...

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Section: Alcohol Constricts Pressurized Cerebral Arteries By a Directsupporting

confidence: 65%

“…Moderate-heavy drinking is associated, independently of any other factor, with an increased risk for stroke and deaths from ischemic stroke (3,4). Binge drinkers are significantly predisposed to brain hemorrhage, cerebrovascular spasm, and stroke (3,5).…”

mentioning

confidence: 99%

Essential role for smooth muscle BK channels in alcohol-induced cerebrovascular constriction

Liu

Xi²,

Ahmed³

et al. 2004

Proc. Natl. Acad. Sci. U.S.A.

171

View full text Add to dashboard Cite

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“…Secondly, many of the prior studies reported that alcohol consumption was an important factor contributing to the prevalence of strokes, [38][39][40] while occupation, which is one of the SES indicators, has also been found to play a crucial role in stroke prevalence. 2,4,6 However, this type of information was not available from the NHIS.…”

Section: Discussionmentioning

confidence: 99%

Urbanization and Stroke Prevalence in Taiwan: Analysis of a Nationwide Survey

Lin

Lin²,

Liu³

et al. 2007

J Urban Health

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This study aims to explore the prevalence of strokes among individuals and the association with urbanization levels. A total sample of 9,794 individuals was obtained from a nationwide survey on Taiwan for subsequent analysis in this study. After adjusting for gender, age, other risk factors for stroke and individual socioeconomic status, a multivariate logistic regression model was employed to investigate the relationships existing between the prevalence of strokes and the level of urbanization. This study finds that those living in areas at the highest level of urbanization (level 1) had the highest prevalence of strokes (2.49%). With decreasing urbanization level, there was a general decline in stroke prevalence. After adjusting for other factors, the multivariate logistic regression analyses showed that compared to participants living in the highest urbanization level, the respective odds ratios of suffering a stroke for those living in areas at the lowest levels of urbanization (levels 7 and 8), were 0.43 and 0.30. We conclude that after adjusting for other stroke risk factors, the level of urbanization is an important contributory factor to the overall prevalence of strokes in Taiwan.

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“…Observational studies suggest a U-or J-shaped association between moderate consumption of alcohol (one to three drinks [15-45 g alcohol] per day) and decreased risk of type 2 diabetes (41,42), coronary heart disease (CHD) (42,43), and stroke (44). However, heavy consumption of alcohol (greater than three drinks per day), may be associated with increased incidence of diabetes (42).…”

Section: Nutrition Recommendations and Interventionsmentioning

confidence: 99%