Red Wine May Mitigate the Risk of Intracerebral Hemorrhage by Preventing Hypertension—A Mendelian Randomization Study Combining CHARLS

Although alcohol is viewed as a risk factor for intracerebral hemorrhage, the causal relationship between different types of alcoholic beverages and intracerebral hemorrhage remains unclear, representing a significant gap in the field of intracerebral hemorrhage prevention. This study aims to fill this gap by investigating how daily drinking habits can help prevent intracerebral hemorrhage. Alcohol, red wine, and white wine were selected to conduct two-sample Mendelian randomization analyses to investigate their associations with intracerebral hemorrhage. Positive results (alcohol, red wine) were further analyzed using multivariable Mendelian randomization to distinguish independent effects. Additionally, hypertension, a risk factor for intracerebral hemorrhage, was utilized for mediation Mendelian randomization analysis to preliminarily explore the mechanisms by which exposure factors influence intracerebral hemorrhage outcomes. Finally, the conclusions were validated in the Chinese population using the CHARLS database and extended the findings. Alcohol was found to be a risk factor (OR = 1.21, <i>p</i>-value = 0.0351). Red wine was found to reduce the risk of ICH (OR = 0.61, <i>p</i>-value = 0.0400). The protective effect of red wine was still observed in the multivariable Mendelian randomization analysis (OR = 0.55, <i>p</i>-value = 0.0442). In the mediation analysis, red wine was found to prevent intracerebral hemorrhage by reducing hypertension (mediation = 13.45%, <i>p</i> = 0.0004). In the CHARLS-based analysis, wine consumption was associated with a lower incidence of hypertension in comparison with teetotalers (OR = 0.54, <i>p</i>-value < 0.0001). Our study revealed that although alcohol is generally considered a risk factor for intracerebral hemorrhage, red wine may have a protective effect against it. This protective effect is partly due to red wine's ability to reduce the incidence of hypertension, and this conclusion can be generalized to different populations.