Abstract
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.
