The Protective Effect of Moderate Alcohol Consumption on Ischemic Stroke

• Published in: JAMA : the journal of the American Medical Association Vol. 281; no. 1; pp. 53 - 60
• Main Authors: Sacco, Ralph L, Elkind, Mitchell, Boden-Albala, Bernadette, Lin, I-Feng, Kargman, Douglas E, Hauser, W. Allen, Shea, Steven, Paik, Myunghee C
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Medical Association 06.01.1999
• Subjects: Adult; African Americans - statistics & numerical data; Aged; Alcohol Drinking - epidemiology; Alcohol use; Biological and medical sciences; Brain Ischemia - epidemiology; Brain Ischemia - prevention & control; Case-Control Studies; Cerebrovascular Disorders - epidemiology; Cerebrovascular Disorders - prevention & control; European Continental Ancestry Group - statistics & numerical data; Female; Health risk assessment; Hispanic Americans; Humans; Male; Medical research; Medical sciences; Middle Aged; Neurology; New York City - epidemiology; Practice Guidelines as Topic; Risk; Statistics as Topic; Stroke; Vascular diseases and vascular malformations of the nervous system; New York City; Human; Nervous system diseases; Cardiovascular disease; Alcohol; Exploration; Cerebral disorder; Vascular disease; Prevention; Alcoholic beverage; Ischemia; Central nervous system disease; Protection; Cerebrovascular disease; Brain (vertebrata)
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.281.1.53

CONTEXT Moderate alcohol consumption has been shown to be protective for coronary heart disease, but the relationship between moderate alcohol consumption and ischemic stroke is more controversial. OBJECTIVE To determine the association between alcohol consumption and risk of ischemic stroke. DESIGN Population-based case-control study conducted between July 1993 and June 1997. SETTING Multiethnic population in northern Manhattan, New York, NY, aged 40 years or older. PATIENTS AND OTHER PARTICIPANTS Cases (n=677) had first ischemic stroke and were matched to community controls (n=1139) derived through random digit dialing by age, sex, and race/ethnicity. Mean ± SD age of cases was 70.0 ± 12.7 years; 55.8% were women; 19.5% were white, 28.4% black, and 50.7% Hispanic. MAIN OUTCOME MEASURE First ischemic stroke (fatal or nonfatal). RESULTS Moderate alcohol consumption, up to 2 drinks per day, was significantly protective for ischemic stroke after adjustment for cardiac disease, hypertension, diabetes, current smoking, body mass index, and education (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.39-0.67). This protective effect of alcohol consumption was detected in both younger and older groups, in men and women, and in whites, blacks, and Hispanics. In a quadratic model of stroke risk, increased risk of ischemic stroke was statistically significant among those consuming 7 or more drinks per day (OR, 2.96; 95% CI, 1.05-8.29). CONCLUSIONS Moderate alcohol consumption was independently associated with a decreased risk of ischemic stroke in our elderly, multiethnic, urban subjects, while heavy alcohol consumption had deleterious effects. Our data support the National Stroke Association Stroke Prevention Guidelines regarding the beneficial effects of moderate alcohol consumption.