STROKE AND ALCOHOL INTAKE IN A HOSPITAL POPULATION - A CASE-CONTROL STUDY

Background and Purpose The aim of the study was to assess whether exce ssive alcohol intake is an independent risk factor for stroke. Methods A case-control study was undertaken in 200 consecutive ischemic and h emorrhagic stroke patients and 372 age and sex-matched control subject s (170 hospital-based and 202 community-based individuals). Data were collected through direct interview regarding demographics, risk factor s for stroke, current daily alcohol consumption, and diagnosis of alco holism. Blood was also taken to test the common biological markers of alcohol intake (erythrocyte mean cell volume, uric acid, aspartate ami notransferase, and gamma-glutamyl transferase). Results After controll ing for the most significant risk factors (antecedent strokes, hyperte nsion, diabetes, smoking) and using hospital control subjects for refe rence, we determined the risk of stroke to be 2.2 (95% confidence inte rval [CI], 1.2 to 4.0) in moderate drinkers (men, less than or equal t o 60 g/d; women, less than or equal to 40 g/d) and 2.9 (95% CI, 1.4 to 6.1) in heavy drinkers (men, >60 g/d; women, >40 g/d). The correspond ing risk values obtained when we compared case subjects and external c ontrol subjects were 1.4 (95% CI, 0.8 to 2.7) and 3.0 (95% CI, 1.3 to 7.0). Even with some fluctuations across groups, the risk did not chan ge significantly after subgroup analysis in men, patients with first-e ver stroke, patients with ischemic stroke, and after exclusion of subj ects with risk factors for stroke. Compared with hospital and external control subjects, stroke patients included a higher proportion of hea vy drinkers (26.6% versus 20.6% versus 10.8%), alcoholics (14.6% versu s 7.7% versus 2.5%), and cases with abnormal erythrocyte mean cell vol ume (63.0% versus 47.6% versus 34.2%) or gamma-glutamyl transferase (3 5.5% versus 32.4% versus 12.9%). Mean alcohol consumption was 42.2 g/d in the case subjects, 30.8 g/d in the hospital control subjects, and 23.2 g/d in the external control subjects. Conclusions The study indic ates that alcohol can be considered an independent risk factor for str oke in Italy.