Intra-population Disparities in Alcohol Consumption and Associated Intracerebral Hemorrhage Risk in East India
Vishal Mehta1, Divya Jyoti2, Ujjawal Sahay3, Rishi Guria4
1Neurology, University of Kentucky College of Medicine, 2Apollo Multispecialty Hospitals, 3Internal Medicine, Shaheed Nirmal Mahto Medical College and Hospital, 4Internal Medicine, Rajendra Institute of Medical Sciences
Objective:
Assessment of the dose-risk relationship between alcohol consumption and Intracerebral Hemorrhage (ICH) and evaluation of the intra-population variations of this risk.
Background:
Heavy alcohol use is attributed to an increased risk of Intracerebral Hemorrhage (ICH), but the association with lesser amounts of alcohol is uncertain. Tribals in East India have a higher prevalence alcohol abuse. ICH risk determination in this population could inform potential risk factor modification strategies. We assessed the dose-risk relationship between alcohol consumption and ICH and evaluated the intra-population variations of this risk.
Design/Methods:
In this case-control study, we recruited 510 patients with ICH. Cases were matched 1:1 with ICH-free controls. Alcohol use was assessed through structured interviews using standardized questionnaires. Alcohol consumption patterns were designated into groups - none, rare, moderate, intermediate, and heavy. The no-alcohol consumption category was used as reference to determine ICH risk. We used regression models to determine ICH risk for different patterns of alcohol consumption and differences in this risk between tribal and non-tribal groups.
Results:
Rare and moderate alcohol consumption conferred a decreased risk of ICH (OR = 0.35, p value < 0.001 and OR = 0.58, p value 0.008 respectively). Patients with heavy alcohol use were at a significantly higher risk (OR = 1.65, p value = 0.027). Subgroup analysis revealed similar risk profiles for rare and moderate consumption in both lobar and non-lobar ICH, whereas heavy alcohol conferred an increased risk only for non-lobar ICH. Heavy alcohol consumption was also associated with risk of ICH in tribals (OR = 3.24. p value = 0.04).
Conclusions:
Our study demonstrated that rare and moderate alcohol consumption may have a protective effect on ICH risk whereas heavy alcohol use is associated with an increased risk. There are intra-population variations in alcohol-related ICH risk with the tribal communities representing an at-risk group.
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