title: Alcohol and acute ischemic stroke onset: the stroke onset study.
abstract: OBJECTIVE
  Previous research suggests that regular heavy alcohol consumption increases the risk for ischemic stroke, whereas frequent light to moderate alcohol intake may decrease the risk. However, the risk of ischemic stroke associated with transient exposure to alcohol remains unclear. In this study, we used a case-crossover approach to test the hypothesis that alcohol consumption affects the acute risk of ischemic stroke, to determine the length of time between alcohol intake and the onset of symptoms (induction time), and to examine whether the risk varies by the type of alcohol.
  
  
  METHODS
  In this multicenter study, we interviewed 390 patients (209 men, 181 women) between January 2001 and November 2006 (median 3 days after stroke). Alcohol consumption in the hour before stroke symptoms was compared with its expected frequency based on the usual frequency of alcohol consumption over the prior year.
  
  
  RESULTS
  Of the 390 patients, 248 (64%) reported alcohol consumption in the prior year, 104 within 24 hours and 14 within 1 hour of stroke onset. The relative risk of stroke in the hour after consuming alcohol was 2.3 (95% CI, 1.4 to 4.0; P=0.002). The relative risks were similar for different types of alcoholic beverages and when the sample was restricted to those who were not simultaneously exposed to other potential triggers.
  
  
  CONCLUSIONS
  The risk of stroke onset is transiently elevated in the hour after alcohol ingestion.
authors.affiliation: Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass 02215, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mostofsky
authors.forename: Mary R
authors.initials: MR
authors.lastname: Burger
authors.forename: Gottfried
authors.initials: G
authors.lastname: Schlaug
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
authors.forename: Wayne D
authors.initials: WD
authors.lastname: Rosamond
authors.forename: Murray A
authors.initials: MA
authors.lastname: Mittleman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D002545:Brain Ischemia / Q000453:epidemiology*; D018592:Cross-Over Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012306:Risk; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013997:Time Factors