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NEW YORK PRESBYTERIAN RESEARCHERS DETERMINE THAT  MODERATE ALCOHOL CONSUMPTION REDUCES STROKE RISK

Study Shows That Up To Two Drinks Per Day Reduces Stroke Risk In Elderly

NEW YORK, NY, January 6, 1999 - Investigators at New York Presbyterian Hospital, Columbia Presbyterian campus, have determined that moderate alcohol consumption by the elderly˜up to two drinks per day˜reduces the risk of the most common type of stroke.  The results of the case-control study, funded by the National  Institute of Neurological Disorders and Stroke, are to be published  in the upcoming January 6 issue of the Journal of the American  Medical Association (JAMA). 

The study is the first to examine the  relationship between alcohol and stroke risk among the elderly of  three different racial/ethnic groups -- Caucasians, African- Americans, and Hispanics. "Many studies have shown that moderate alcohol consumption protects against cardiac disease, but until now, its relationship with stroke risk was less certain.  Our study provides  the first important evidence that moderate alcohol use is associated  with a significantly decreased risk of ischemic stroke in a  multiethnic, urban, elderly population,"  notes Ralph L. Sacco, M.D.,   M.S., Associate Professor of Neurology and Public Health at the  Gertrude H. Sergievsky Center at Columbia Presbyterian. 

Previous studies have suggested that moderate alcohol consumption protects against ischemic stroke (where a blood clot blocks a blood vessel in the brain) in certain populations, while other studies have found no beneficial effect. It has also been speculated that the relationship  between alcohol and stroke risk varies according to race/ethnicity,  as studies in Caucasian populations have found alcohol to have a  protective effect, while those in Asian populations have not.  Studies  of  African-American populations have yielded conflicting results,  while prior to the Columbia Presbyterian investigation, no study had  addressed the relationship between alcohol and stroke among Hispanics. 

The study examined data from the Northern Manhattan Stroke Study  (NOMASS), one of the first population-based studies to compare stroke incidence among Caucasians, African-Americans and Hispanics living in  the same community.  Over four years, 677 patients with ischemic stroke were matched by age, sex, and race/ethnicity with subjects who had never suffered a stroke. The mean age of the study population was 70.  

The case-control analysis showed moderate daily alcohol use in the  preceding year was protective against ischemic stroke, even after  adjustment for hypertension (high blood pressure), diabetes, cardiac  disease, current smoking, education, and body mass index. "We found  this protective effect no matter what type of alcohol was consumed,  whether it was wine, beer, or liquor. This is in accord with the  majority of studies of the protective effect of alcohol on coronary  artery disease,"  observes Dr. Sacco. 

The study showed that heavy  alcohol consumption --  seven or more drinks per day -- was associated with  increased stroke risk. But former heavy drinkers who decreased their  consumption to no more than two drinks per day were able to reduce  their risk. While the protective effect of alcohol on heart disease  appears to be at least partially related to levels of high-density  lipoprotein (HDL, or the so-called good cholesterol), the relative  importance of HDL in mediating alcohol's effect on stroke risk has  not been well studied. 

Data from the Columbia Presbyterian study suggest that the protective effect of alcohol was independent of HDL.  "While no study has shown a benefit in recommending alcohol use to  people who don't drink, our data support the view, endorsed by the  National Stroke Association in its Stroke Prevention Guidelines,   that among those who are moderate drinkers, continued consumption may  provide a reduction of ischemic stroke risk," says Dr. Sacco.  "These  benefits, of course, must be weighed against the overall risk of  morbidity and mortality due to excess alcohol consumption."