Journal of Stroke & Cerebrovascular Diseases
Volume 18, Issue 5 , Pages 384-388 , September 2009

Apolipoprotein E, Alcohol Consumption, and Risk of Ischemic Stroke: The Framingham Heart Study Revisited

  • Luc Djoussé, MD, DSc

      Affiliations

    • Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
    • Corresponding Author InformationAddress correspondence to Luc Djoussé, MD, MPH, DSc, FAHA, Division of Aging, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont St, 3rd Floor, Boston, MA 02120.
  • ,
  • Jayandra J. Himali, MS

      Affiliations

    • Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
    • National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts
  • ,
  • Alexa Beiser, PhD

      Affiliations

    • Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
    • National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts
    • Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
  • ,
  • Margaret Kelly-Hayes, EdD, RN

      Affiliations

    • National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts
    • Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
  • ,
  • Philip A. Wolf, MD

      Affiliations

    • National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts
    • Department of Neurology, Boston University School of Medicine, Boston, Massachusetts

Received 11 December 2008 ,Revised 13 January 2009 ,Accepted 20 January 2009.

References 

  1. Rosamond W, Flegal K, Furie K, et al. Heart disease and stroke statistics–2008 update: A report from the American Heart Association statistics committee and stroke statistics subcommittee. Circulation. 2008;117:e25–146
  2. Carandang R, Seshadri S, Beiser A, et al. Trends in incidence, lifetime risk, severity, and 30-day mortality of stroke over the past 50 years. JAMA. 2006;296:2939–2946
  3. Taylor TN, Davis PH, Torner JC, et al. Lifetime cost of stroke in the United States. Stroke. 1996;27:1459–1466
  4. Diringer MN, Edwards DF, Mattson DT, et al. Predictors of acute hospital costs for treatment of ischemic stroke in an academic center. Stroke. 1999;30:724–728
  5. Djousse L, Ellison RC, Beiser A, et al. Alcohol consumption and risk of ischemic stroke: The Framingham study. Stroke. 2002;33:907–912
  6. Daniel S, Bereczki D. Alcohol as a risk factor for hemorrhagic stroke. Ideggyogyaszati Szemle. 2004;57:247–256
  7. Reynolds K, Lewis B, Nolen JD, et al. Alcohol consumption and risk of stroke: A meta-analysis. JAMA. 2003;289:579–588
  8. Gaziano JM, Buring JE, Breslow JL, et al. Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med. 1993;329:1829–1834
  9. Sacanella E, Vazquez-Agell M, Mena MP, et al. Down-regulation of adhesion molecules and other inflammatory biomarkers after moderate wine consumption in healthy women: A randomized trial. Am J Clin Nutr. 2007;86:1463–1469
  10. Covas MI, Konstantinidou V, Mysytaki E, et al. Postprandial effects of wine consumption on lipids and oxidative stress biomarkers. Drugs Exp Clin Res. 2003;29:217–223
  11. Sierksma A, van der Gaag MS, Kluft C, et al. Moderate alcohol consumption reduces plasma C-reactive protein and fibrinogen levels; a randomized, diet-controlled intervention study. Eur J Clin Nutr. 2002;56:1130–1136
  12. Stewart SH. Alcohol and inflammation: A possible mechanism for protection against ischemic heart disease. Nutr Metab Cardiovasc Dis. 2002;12:148–151
  13. Rimm EB, Williams P, Fosher K, et al. Moderate alcohol intake and lower risk of coronary heart disease: Meta-analysis of effects on lipids and hemostatic factors. BMJ. 1999;319:1523–1528
  14. Wilson PW, Schaefer EJ, Larson MG, et al. Apolipoprotein E alleles and risk of coronary disease: A meta-analysis. Arterioscler Thromb Vasc Biol. 1996;16:1250–1255
  15. Tiret L, de Knijff P, Menzel HJ, et al. ApoE polymorphism and predisposition to coronary heart disease in youths of different European populations: The EARS study (European atherosclerosis research study). Arterioscler Thromb. 1994;14:1617–1624
  16. Woo D, Kaushal R, Chakraborty R, et al. Association of apolipoprotein E4 and haplotypes of the apolipoprotein E gene with lobar intracerebral hemorrhage. Stroke. 2005;36:1874–1879
  17. Souza DR, Campos BF, Arruda EF, et al. Influence of the polymorphism of apolipoprotein E in cerebral vascular disease. Arq Neuropsiquiatr. 2003;61:7–13
  18. Ferrucci L, Guralnik JM, Pahor M, et al. Apolipoprotein E epsilon 2 allele and risk of stroke in the older population. Stroke. 1997;28:2410–2416
  19. Farrer LA, Cupples LA, Kukill WA, et al. Risk of Alzheimer disease is associated with parental age among apolipoprotein E 4 heterozygotes. Alzheimer Res. 1997;3:83–91
  20. Harwood DG, Barker WW, Ownby RL, et al. Apolipoprotein E polymorphism and age of onset for Alzheimer's disease in a bi-ethnic sample. Int Psychogeriatr. 2004;16:317–326
  21. Olarte L, Schupf N, Lee JH, et al. Apolipoprotein E epsilon4 and age at onset of sporadic and familial Alzheimer disease in Caribbean Hispanics. Arch Neurol. 2006;63:1586–1590
  22. Djousse L, Pankow JS, Arnett DK, et al. Apolipoprotein E polymorphism modifies the alcohol-HDL association observed in the National Heart, Lung, and Blood Institute family heart study. Am J Clin Nutr. 2004;80:1639–1644
  23. Dawber TR, Kannel WB, McNamara PM, et al. An epidemiologic study of apoplexy (“strokes”): Observations in 5,209 adults in the Framingham study on association of various factors in the development of apoplexy. Trans Am Neurol Assoc. 1965;90:237–240
  24. Kannel WB, Feinleib M, McNamara PM, et al. An investigation of coronary heart disease in families: The Framingham offspring study. Am J Epidemiol. 1979;110:281–290
  25. Djousse L, Dorgan JF, Zhang Y, et al. Alcohol consumption and risk of lung cancer: The Framingham Study. J Natl Cancer Inst. 2002;94:1877–1882
  26. Djousse L, Levy D, Benjamin EJ, et al. Long-term alcohol consumption and the risk of atrial fibrillation: The Framingham study. Am J Cardiol. 2004;93:710–713
  27. Wolf PA, D'Agostino RB, Belanger AJ, et al. Probability of stroke: A risk profile from the Framingham study. Stroke. 1991;22:312–318
  28. Hixson JE, Vernier DT. Restriction isotyping of human apolipoprotein E by gene amplification and cleavage with HhaI. J Lipid Res. 1990;31:545–548
  29. Warnick GR, Benderson J, Albers JJ. Dextran sulfate-Mg2+ precipitation procedure for quantitation of high-density-lipoprotein cholesterol. Clin Chem. 1982;28:1379–1388
  30. Lipid Research Clinics Program . Manual of laboratory and operations, Vol 1: Lipid and lipoprotein analysis. DHEW publication No. (National Institutes of Health) 75-628. Bethesda, MD: National Institutes of Health; 1974;
  31. Beulens JW, van Loon LJ, Kok FJ, et al. The effect of moderate alcohol consumption on adiponectin oligomers and muscle oxidative capacity: A human intervention study. Diabetologia. 2007;50:1388–1392
  32. Davies MJ, Baer DJ, Judd JT, et al. Effects of moderate alcohol intake on fasting insulin and glucose concentrations and insulin sensitivity in postmenopausal women: A randomized controlled trial. JAMA. 2002;287:2559–2562
  33. Beulens JW, de Zoete EC, Kok FJ, et al. Effect of moderate alcohol consumption on adipokines and insulin sensitivity in lean and overweight men: A diet intervention study. Eur J Clin Nutr. 2007;62:1098–1105
  34. Sierksma A, Patel H, Ouchi N, et al. Effect of moderate alcohol consumption on adiponectin, tumor necrosis factor-alpha, and insulin sensitivity. Diabetes Care. 2004;27:184–189
  35. Djousse L, Biggs ML, Mukamal KJ, et al. Alcohol consumption and type 2 diabetes among older adults: The cardiovascular health study. Obesity. 2007;15:1758–1765

 Supported by the National Heart, Lung, and Blood Institute's (NHLBI) Framingham Heart Study contract No. N01-HC-25195, National Institute of Health, Bethesda, MD, and a grant from the National Institute of Neurological Disorders and Stroke (5RO1-NS 017950, Philip A. Wolf, MD, Principal Investigator). Dr. Djoussé was partially supported by K01 HL-70444 from the NHLBI.

PII: S1052-3057(09)00023-8

doi: 10.1016/j.jstrokecerebrovasdis.2009.01.008

Journal of Stroke & Cerebrovascular Diseases
Volume 18, Issue 5 , Pages 384-388 , September 2009