title: Moderate alcohol consumption reduces risk of ischemic stroke: the Northern Manhattan Study.
abstract: OBJECTIVE
  Moderate alcohol consumption is protective against coronary disease, but its relationship to ischemic stroke (IS) is controversial.
  
  
  METHODS
  Stroke-free participants > or =40 years of age identified by random-digit dialing were enrolled in a prospective cohort study between 1993 and 2001. Alcohol consumption was assessed through in-person interview and categorized as none in the past year, > or =1 drink in past month to < or =2 per day (moderate drinkers), and >2 drinks daily. Lifetime drinking was also assessed. Cox proportional hazard regression modeling was used to assess hazard ratios and their 95% CIs for the association of drinking with risk of stroke and vascular events.
  
  
  RESULTS
  Mean age among participants (n=3176) was 69.1+/-10.3 years; 62.8% were women, 20.8% were non-Hispanic white, 24.5% non-Hispanic black, and 52.4% were Hispanic. No alcohol in the previous year was present in 62.3%, and 32.5% drank moderately. After adjusting for other risk factors compared with those who did not drink in the past year, moderate drinkers had a reduced risk of IS (0.67; 95% CI, 0.46 to 0.99) and IS, myocardial infarction, or vascular death (0.74; 95% CI, 0.59 to 0.94). Results were similar when never-drinkers were used as referent group. Reduction in risk was seen for nonatherosclerotic IS subtypes, and results stratified by age, sex, and race-ethnicity were similar.
  
  
  CONCLUSIONS
  Moderate alcohol consumption is associated with decreased risk of IS in a multiethnic population. This effect is independent of other risk factors and holds for nonatherosclerotic stroke subtypes.
authors.affiliation: Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA. mse13@columbia.edu
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.forename: Robert
authors.initials: R
authors.lastname: Sciacca
authors.forename: Bernadette
authors.initials: B
authors.lastname: Boden-Albala
authors.forename: Tanja
authors.initials: T
authors.lastname: Rundek
authors.forename: Myunghee C
authors.initials: MC
authors.lastname: Paik
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D002319:Cardiovascular System / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009518:New York; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D012306:Risk; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome