Moderate Drinking Appears
to Guard Against Stroke
>By Merritt McKinney
c.1999 Medical Tribune News Service
Here's another reason to say 'cheers': A new study suggests that having a drink or two each day may reduce the risk of having the most common type of stroke.
But moderation appears to be important, because the same study found that heavy drinkers are more likely to suffer a stroke.
The association between moderate drinking and a reduced risk of heart attack is well documented, but the evidence for a connection between alcohol and stroke is less conclusive, according to one of the study's authors, Dr. Mitchell Elkind, an assistant professor of neurology at Columbia University and New York Presbyterian Hospital in New York. Some studies have found that moderate drinkers are less likely to have a stroke, while others have shown no such connection, he said in an interview.
But in the new study, which was based on a sample of 677 stroke survivors and a control group of 1,139 people who had not had a stroke, Elkind and his colleagues found that those who drank up to two drinks a day were about half as likely as nondrinkers to have an ischemic stroke. About 80 percent of strokes are of this variety, which occur when a blood clot or other blockage prevents blood from reaching the brain.
``It's a good study that tells us that there is a protecting effect of alcohol,'' commented Dr. Edgar J. Kenton, a clinical professor of neurology at Thomas Jefferson University Medical School in Philadelphia. The study is important, because it is the first one to look at an ethnically diverse sample, according to Kenton, who is a member of the executive committee of the American Heart Association (AHA) Stroke Council.
Among the mostly elderly participants, all of whom lived in the northern part of New York City, about 20 percent were white, nearly 30 percent were black and about half were Hispanic, according to the report. The connection between moderate drinking and reduced stroke risk held true for all groups, according to the report in Wednesday's issue of the Journal of the American Medical Association (JAMA).
How alcohol may protect against stroke is unclear, because the researchers did not find that it had an effect on HDL cholesterol, Kenton said, explaining that some scientists have suggested that alcohol raises levels of this ``good'' cholesterol.
``There's something else going on'' when a person drinks that must account for the reduction in risk, Kenton said.
Elkind speculated that alcohol somehow may act on substances in the blood known as platelets, which play a role in how blood clots.
Although some studies have shown that wine drinkers may receive the greatest benefit to the heart, whether a person drank beer, wine, liquor or a combination did not have an effect on the association, the study showed. In the study, one drink equalled about four ounces of wine, 12 ounces of beer or one and a half ounces of liquor.
The bottom line from this study, according to Elkind, is that moderate drinking can be a part of a healthy lifestyle, although he stressed that nondrinkers should not feel pressured to begin drinking. Despite its apparent benefits, alcohol can cause serious health problems, including liver disease and high blood pressure, he said. Whether drinking can be a part of a healthy lifestyle depends on a person's own risk factors, Elkind explained.
But hopefully the study will encourage some heavy drinkers to lay off the bottle a bit, he said.
Compared to nondrinkers, people who drank seven or more drinks per day were nearly three times as likely to have a stroke, the researchers reported.
But ``it's not over because you used to be a heavy drinker,'' according to Elkind. The researchers found that heavy drinkers who cut down to two or fewer drinks a day were able to eliminate the increased risk of stroke.
For more information on the health risks and benefits of alcohol, visit the JAMA Patient Page for this study on the Web at