PT  - JOURNAL ARTICLE
AU  - Ching-Jen Chen
AU  - W. Mark Brown
AU  - Charles J. Moomaw
AU  - Carl D. Langefeld
AU  - Jennifer Osborne
AU  - Bradford B. Worrall
AU  - Daniel Woo
AU  - Sebastian Koch
AU  - For the ERICH Investigators
TI  - Alcohol use and risk of intracerebral hemorrhage
AID  - 10.1212/WNL.0000000000003952
DP  - 2017 Apr 26
TA  - Neurology
PG  - 10.1212/WNL.0000000000003952
4099  - http://n.neurology.org/content/early/2017/04/26/WNL.0000000000003952.short
4100  - http://n.neurology.org/content/early/2017/04/26/WNL.0000000000003952.full
AB  - Objective: To analyze the dose–risk relationship for alcohol consumption and intracerebral hemorrhage (ICH) in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study.Methods: ERICH is a multicenter, prospective, case-control study, designed to recruit 1,000 non-Hispanic white patients, 1,000 non-Hispanic black patients, and 1,000 Hispanic patients with ICH. Cases were matched 1:1 to ICH-free controls by age, sex, race/ethnicity, and geographic area. Comprehensive interviews included questions regarding alcohol consumption. Patterns of alcohol consumption were categorized as none, rare (<1 drink per month), moderate (≥1 drink per month and ≤2 drinks per day), intermediate (>2 drinks per day and <5 drinks per day), and heavy (≥5 drinks per day). ICH risk was calculated using the no-alcohol use category as the reference group.Results: Multivariable analyses demonstrated an ordinal trend for alcohol consumption: rare (odds ratio [OR] 0.57, p < 0.0001), moderate (OR 0.65, p < 0.0001), intermediate (OR 0.82, p = 0.2666), and heavy alcohol consumption (OR 1.77, p = 0.0003). Subgroup analyses demonstrated an association of rare and moderate alcohol consumption with decreased risk of both lobar and nonlobar ICH. Heavy alcohol consumption demonstrated a strong association with increased nonlobar ICH risk (OR 2.04, p = 0.0003). Heavy alcohol consumption was associated with significant increase in nonlobar ICH risk in black (OR 2.34, p = 0.0140) and Hispanic participants (OR 12.32, p < 0.0001). A similar association was not found in white participants.Conclusions: This study demonstrated potential protective effects of rare and moderate alcohol consumption on ICH risk. Heavy alcohol consumption was associated with increased ICH risk. Race/ethnicity was a significant factor in alcohol-associated ICH risk; heavy alcohol consumption in black and Hispanic participants poses significant nonlobar ICH risk.