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(Stroke. 2006;37:1.)
© 2006 American Heart Association, Inc.

Editorial

Is There a Causal Relationship Between the Amount of Alcohol Consumption and Stroke Risk?

Larry B. Goldstein, MD, FAAN

From the Center for Cerebrovascular Disease, Center for Clinical Health Policy Research, Duke University, and the Durham VA Medical Center, Durham, NC.

Correspondence to Larry B. Goldstein, MD, Box 3651, Duke University Medical Center, Durham, NC 27710. E-mail golds004@mc.duke.edu

Key Words: alcohol • prevention • risk factors • stroke

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 13–19

In a review of the topic, Gorelick noted that alcohol consumption has been recognized as a possible risk factor for stroke for over 3 centuries.¹ Subsequent studies find that the association between drinking alcohol and stroke risk is not straightforward. Literature on the subject is complicated by nonstandardized definitions of the level of alcohol consumption, varying study designs, inadequate sample sizes, differing inception cohorts, as well as case-ascertainment and other potential biases. It is therefore not surprising that a systematic literature review revealed that individual studies report inconsistent relationships between the overall amount of alcohol use and stroke (although most show an association between recent use and increased stroke risk).² However, the weight of available evidence indicates that light to moderate drinking is associated with a protective effect, whereas heavy consumption is associated with an increased risk of stroke (a so-called "J-shaped" or "U-shaped" relationship).^3–6 This relationship is supported by a meta-analysis that identified 35 relevant cohort or case-control studies published between 1966 and April, 2002, which found that, as compared with abstention, consumption of less than 12 g (1 drink) of alcohol per day is associated with 20% reductions in both ischemic (relative risk [RR]=0.80, 95% CI, 0.67 to 0.96) and total stroke (RR=0.83, 95% CI, 0.75 to 0.91), whereas >6 drinks per day is associated with increased risks of both ischemic (RR=1.69, 95% CI, 1.34 to 2.15) and total stroke (RR=1.64, 95% CI, 1.39 to 1.93).⁷

Consistent with the overall results . . . [Full Text of this Article]

Related Article:

Moderate Alcohol Consumption Reduces Risk of Ischemic Stroke: The Northern Manhattan Study

Mitchell S.V. Elkind, Robert Sciacca, Bernadette Boden-Albala, Tanja Rundek, Myunghee C. Paik, and Ralph L. Sacco
Stroke 2006 37: 13-19. [Abstract] [Full Text] [PDF]