Moderate Drinking May Lower the Risk of Ischemic Stroke

While moderate drinking appears to protect against coronary disease, its effects on stroke are less clear. To examine whether alcohol use can reduce the risk of stroke and other vascular events, researchers assessed 3176 subjects from Manhattan with no history of stroke (mean age 69 years, 63% female, 52% Hispanic, and 25% non-Hispanic black). During a median of 6 years of follow-up, 190 subjects had a stroke.

• In analyses adjusted for potential confounders (e.g., diabetes, smoking), moderate drinkers had a lower risk of ischemic stroke (odds ratio [OR] 0.7) and of either ischemic stroke, myocardial infarction, or vascular death (OR 0.7) than did subjects who rarely drank.*
• This reduced risk was significant for the cryptogenic subtype (OR 0.3), borderline significant for the lacunar and cardioembolic subtypes (ORs 0.4 and 0.5, respectively), and not significant for the atherosclerotic subtype (OR 0.8).
• In analyses stratified by age, sex, and race, the reduced risk of ischemic stroke was significant only among subjects aged 70 or older and borderline significant for women, Hispanics, and nonsmokers.
• Heavier drinking* did not significantly affect risk.

Comments:

While not large, this population-based prospective study among whites, blacks, and Hispanics showed an approximately 30% lower risk of ischemic stroke in moderate drinkers. This finding is consistent with results from most other recent studies. Small numbers likely accounted for the varied results across stroke subtypes, the limited findings for subjects with hemorrhagic stroke, and the lack of significance associated with heavier drinking.

R. Curtis Ellison, MD

Reference:

Elkind MSV, Sciacca R, Boden-Albala B, et al. Moderate alcohol consumption reduces risk of ischemic stroke: the Northern Manhattan Study. Stroke. 2006;37(1):13–19.