Light-to-moderate alcohol consumption and the risk of stroke among US malephysicians.

Background: Several studies have shown U- or J-shaped relations between alc ohol consumption and the risk of stroke. We evaluated the effect of light-t o-moderate alcohol intake on the risk of stroke, with separate analyses of ischemic stroke and hemorrhagic stroke. Methods: Our analyses were based on a prospective cohort study of 22,071 ma le physicians, 40 to 84 years old, who were participating in the Physicians ' Health Study. At base line, the participants reported that they had no hi story of stroke, transient ischemic attack, or myocardial infarction and we re free of cancer. Alcohol intake, reported by 21,870 participants at base line, ranged from none or almost none to two or more drinks per day. Results: During an average of 12.2 years of follow-up, 679 strokes were rep orted. As compared with participants who had less than one drink per week, those who drank more had a reduced overall risk of stroke (relative risk, 0 .79; 95 percent confidence interval, 0.66 to 0.94) and a reduced risk of is chemic stroke (relative risk, 0.77; 95 percent confidence interval, 0.63 to 0.94). There was no statistically significant association between alcohol consumption and hemorrhagic stroke. The overall relative risks of stroke fo r the men who had one drink per week, two to four drinks per week, five or six drinks per week, or one or more drinks per day were 0.78 (95 percent co nfidence interval, 0.59 to 1.04), 0.75 (95 percent confidence interval, 0.5 8 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 factors for stroke. Conclusions: Light-to-moderate alcohol consumption reduces the overall 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 increase the observed benefit. (N Engl J Med 1999;341:155 7-64.) (C) 1999, Massachusetts Medical Society.