• R L Sacco, M Elkind, B Boden-Albala, I F Lin, D E Kargman, W A Hauser, S Shea, and M C Paik.
• Department of Neurology, Sergievsky Center, Columbia University College of Physicians and Surgeons, New York, NY, USA. rls1@columbia.edu
• JAMA. 1999 Jan 6; 281 (1): 536053-60.

ContextModerate 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.ObjectiveTo determine the association between alcohol consumption and risk of ischemic stroke.DesignPopulation-based case-control study conducted between July 1993 and June 1997.SettingMultiethnic population in northern Manhattan, New York, NY, aged 40 years or older.Patients And Other ParticipantsCases (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 MeasureFirst ischemic stroke (fatal or nonfatal).ResultsModerate 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).ConclusionsModerate 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.

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