Alcohol Consumption, Social Support, and Risk of Stroke and Coronary Heart Disease Among Japanese Men: The JPHC Study

Authors

  • Satoyo Ikehara,

    1. From the Public Health, Department of Social and Environmental Medicine (SI, HI), Osaka University, Graduate School of Medicine, Osaka, Japan; Department of Public Health Medicine (KY), Graduate School of Comprehensive Human Sciences, Institute of Community Medicine, University of Tsukuba, Tsukuba, Japan; Cancer Information Services and Surveillance Division (SY), Center for Cancer Control and Information Service, National Cancer Center, Tokyo, Japan; and Epidemiology and Prevention Division (MI, ST), Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
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  • Hiroyasu Iso,

    1. From the Public Health, Department of Social and Environmental Medicine (SI, HI), Osaka University, Graduate School of Medicine, Osaka, Japan; Department of Public Health Medicine (KY), Graduate School of Comprehensive Human Sciences, Institute of Community Medicine, University of Tsukuba, Tsukuba, Japan; Cancer Information Services and Surveillance Division (SY), Center for Cancer Control and Information Service, National Cancer Center, Tokyo, Japan; and Epidemiology and Prevention Division (MI, ST), Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
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  • Kazumasa Yamagishi,

    1. From the Public Health, Department of Social and Environmental Medicine (SI, HI), Osaka University, Graduate School of Medicine, Osaka, Japan; Department of Public Health Medicine (KY), Graduate School of Comprehensive Human Sciences, Institute of Community Medicine, University of Tsukuba, Tsukuba, Japan; Cancer Information Services and Surveillance Division (SY), Center for Cancer Control and Information Service, National Cancer Center, Tokyo, Japan; and Epidemiology and Prevention Division (MI, ST), Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
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  • Seiichiro Yamamoto,

    1. From the Public Health, Department of Social and Environmental Medicine (SI, HI), Osaka University, Graduate School of Medicine, Osaka, Japan; Department of Public Health Medicine (KY), Graduate School of Comprehensive Human Sciences, Institute of Community Medicine, University of Tsukuba, Tsukuba, Japan; Cancer Information Services and Surveillance Division (SY), Center for Cancer Control and Information Service, National Cancer Center, Tokyo, Japan; and Epidemiology and Prevention Division (MI, ST), Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
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  • Manami Inoue,

    1. From the Public Health, Department of Social and Environmental Medicine (SI, HI), Osaka University, Graduate School of Medicine, Osaka, Japan; Department of Public Health Medicine (KY), Graduate School of Comprehensive Human Sciences, Institute of Community Medicine, University of Tsukuba, Tsukuba, Japan; Cancer Information Services and Surveillance Division (SY), Center for Cancer Control and Information Service, National Cancer Center, Tokyo, Japan; and Epidemiology and Prevention Division (MI, ST), Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
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  • Shoichiro Tsugane,

    1. From the Public Health, Department of Social and Environmental Medicine (SI, HI), Osaka University, Graduate School of Medicine, Osaka, Japan; Department of Public Health Medicine (KY), Graduate School of Comprehensive Human Sciences, Institute of Community Medicine, University of Tsukuba, Tsukuba, Japan; Cancer Information Services and Surveillance Division (SY), Center for Cancer Control and Information Service, National Cancer Center, Tokyo, Japan; and Epidemiology and Prevention Division (MI, ST), Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
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  • the JPHC Study Group

    1. From the Public Health, Department of Social and Environmental Medicine (SI, HI), Osaka University, Graduate School of Medicine, Osaka, Japan; Department of Public Health Medicine (KY), Graduate School of Comprehensive Human Sciences, Institute of Community Medicine, University of Tsukuba, Tsukuba, Japan; Cancer Information Services and Surveillance Division (SY), Center for Cancer Control and Information Service, National Cancer Center, Tokyo, Japan; and Epidemiology and Prevention Division (MI, ST), Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
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Reprint requests: Dr. Shoichiro Tsugane, PhD, MD, Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 Japan; Fax: +81-3-3547-8578; E-mail: stsugane@ncc.go.jp; and Hiroyasu Iso, PhD, MD, MPH, Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871 Japan; Fax: +81-6-6879-3919; E-mail: fvgh5640@mb.infoweb.ne.jp

Abstract

Background:  It is unclear whether the association between alcohol consumption and risk of cardiovascular disease is affected by social support.

Methods:  The prospective data for 19,356 men aged 40 to 69 years who participated in the Japan Public Health Center-Based Prospective Study. Alcohol consumption was classified into 7 categories: never, past, occasional, 1 to 149, 150 to 299, 300 to 449, or ≥450 g ethanol/wk. Associations between alcohol consumption and risk of cardiovascular disease were stratified by the median level of social support score, which was measured in emotional support score of this cohort study.

Results:  During an average follow-up of 9.9 years, 629 total strokes and 207 coronary heart diseases were documented. Light-to-moderate alcohol consumption was associated with reduced risks of coronary heart disease and total cardiovascular disease, while heavy alcohol consumption was associated with increased risk of total stroke, in particular hemorrhagic stroke. When stratified by social support score, the multivariable hazard ratios of total cardiovascular disease associated with light-to-moderate alcohol consumption (1 to 299 g/wk) were 0.99 (0.72 to 1.37) in the low social support group and 0.56 (0.44 to 0.70) in the high social support group (p for interaction = 0.002), while the multivariable hazard ratios of hemorrhagic stroke associated with heavy alcohol consumption (≥300 g/wk) were 2.09 (1.03 to 4.27) in the low social support group and 1.25 (0.72 to 2.15) in the high social support group (p for interaction = 0.44). There was no interaction between alcohol consumption and social support in relation to risk of coronary heart disease.

Conclusions:  Social support may enhance the beneficial effect of light-to-moderate alcohol consumption on risk of cardiovascular disease.

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