Neurology: Alcohol consumption is a risk factor for acute stroke

The relationship between alcohol consumption and stroke is uncertain, especially low-moderate drinking
.
Recently, a research article was published in Neurology, a leading journal in the field of neurology, in which researchers explored these associations
in a large international study.

INTERSTROKE is a case-control study and the largest international study of risk factors for
acute stroke.
Alcohol intake was self-reported by participants and was classified as low (1-7), moderate (7-14 women, 7-21 men), or high (>14 women, >21 men)
according to weekly alcohol consumption.
Heavy incidental drinking (HED) is defined as drinking more than 1 day and more than
5 times a month.
Multivariate conditional logistic regression is used to determine correlation
.

The investigators included 12,913 cases and 12,935 controls; 25.
0% (n=6449) were current drinkers, 16.
7% (n=4318) were previous drinkers, and 58.
3% (n=15076) were never-drinkers
.
Current drinkers are young, male, smoked, active, and in high-paying
occupations.
Current alcohol consumption is associated with all strokes (OR 1.
14; 95% CI 1.
04 to 1.
26) and intracerebral haemorrhage (OR 1.
50, 95% CI 1.
21 to 1.
84), but associated with ischaemic stroke (OR 1.
06; 95% CI 0.
95 to 1.
19) unrelated
.
The HED pattern was associated with all strokes (OR 1.
39; 95% CI 1.
21 to 1.
59), ischaemic stroke (OR 1.
29; 95% CI 1.
10 to 1.
51) and ICH (OR 1.
76; 95% confidence interval 1.
31 to 2.
36) correlated
.

High alcohol intake is consistently associated with
all strokes, ischaemic strokes, and intracerebral haemorrhages.
Moderate alcohol consumption is associated with all strokes and intracerebral hemorrhage, but not
ischaemic stroke.
Overall, low alcohol intake was not associated with stroke, but there were regional differences; In Western Europe/North America, low intake was associated with a reduced chance of stroke (OR 0.
66; 95% CI 0.
45 to 0.
96), India had an increased probability (OR 2.
18; 95% CI 1.
42--3.
36) (interaction p=0.
037).

Wine consumption was associated with a reduced incidence of all strokes and ischaemic strokes, but not
with intracerebral haemorrhage.
The extent of this association was greatest
in those individuals who did not have high blood pressure and were smoking.

It follows that high and moderate alcohol intake is associated with an increased chance of stroke, while low intake is not
associated with stroke.
However, there are also important regional differences, which may be related
to differences in the demographics, types or patterns of drinkers.

Original source:

Andrew Smyth,et al.
Alcohol Intake as a Risk Factor for Acute Stroke: The INTERSTROKE Study.
Neurology.
2022.
https://n.
neurology.
org/content/early/2022/10/11/WNL.
0000000000201388