Light-to-Moderate Alcohol Consumption and the Risk of Stroke among U.S. Male Physicians
Klaus Berger, M.D., M.P.H., Umed A. Ajani, M.B., B.S., M.P.H., Carlos S. Kase, M.D., J. Michael Gaziano, M.D., Julie E. Buring, Sc.D., Robert J. Glynn, Ph.D., and Charles H. Hennekens, M.D., D.P.H.
Background Several studies have shown U- or J-shaped relationsbetween alcohol consumption and the risk of stroke. We evaluatedthe effect of light-to-moderate alcohol intake on the risk ofstroke, with separate analyses of ischemic stroke and hemorrhagicstroke.
Methods Our analyses were based on a prospective cohort studyof 22,071 male physicians, 40 to 84 years old, who were participatingin the Physicians' Health Study. At base line, the participantsreported that they had no history of stroke, transient ischemicattack, or myocardial infarction and were free of cancer. Alcoholintake, reported by 21,870 participants at base line, rangedfrom none or almost none to two or more drinks per day.
Results During an average of 12.2 years of follow-up, 679 strokeswere reported. As compared with participants who had less thanone drink per week, those who drank more had a reduced overallrisk of stroke (relative risk, 0.79; 95 percent confidence interval,0.66 to 0.94) and a reduced risk of ischemic stroke (relativerisk, 0.77; 95 percent confidence interval, 0.63 to 0.94). Therewas no statistically significant association between alcoholconsumption and hemorrhagic stroke. The overall relative risksof stroke for the men who had one drink per week, two to fourdrinks per week, five or six drinks per week, or one or moredrinks per day were 0.78 (95 percent confidence interval, 0.59to 1.04), 0.75 (95 percent confidence interval, 0.58 to 0.96),0.83 (95 percent confidence interval, 0.62 to 1.11), and 0.80(95 percent confidence interval, 0.64 to 0.99), respectively,in an analysis in which we controlled for major risk factorsfor stroke.
Conclusions Light-to-moderate alcohol consumption reduces theoverall risk of stroke and the risk of ischemic stroke in men.The benefit is apparent with as little as one drink per week.Greater consumption, up to one drink per day, does not increasethe observed benefit.
Source Information
From the Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital (K.B., U.A.A., J.M.G., J.E.B., R.J.G.); the Massachusetts Veterans Epidemiology Research and Information Center, Department of Veterans Affairs Boston Healthcare System (J.M.G.); the Department of Ambulatory Care and Prevention, Harvard Medical School (J.E.B.); the Department of Biostatistics, Harvard School of Public Health (R.J.G.); the Department of Neurology, Boston University School of Medicine (C.S.K.) — all in Boston; the Institute of Epidemiology and Social Medicine and the Department of Neurology, University of Muenster, Muenster, Germany (K.B.); and the Department of Epidemiology and Public Health, University of Miami School of Medicine, Miami (C.H.H.).
Address reprint requests to Dr. Ajani at the Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Ave. E., Boston, MA 02215, or at uajani{at}rics.bwh.harvard.edu.
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