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  • 1From the Population Health Research Institute (A.S., M.O.D., S.R., S.Y.), McMaster University and Hamilton Health Sciences, ON, Canada; HRB Clinical Research Facility Galway (A.S., M.O.D., M.C., C.M.), Department of Medicine, University of Galway, Ireland; Medical School (G.J.H.), Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; St John's Medical College and Research Institute (D.X.), Bangalore, India; Beijing Hypertension League Institute (H.Z.), China; Faculty of Medicine (A.D.), Eduardo Mondlane University, Maputo, Mozambique; Hospital Alemao Oswaldo Cruz (A.A.), Sao Paulo, Brazil; National Medical Research Center of Cardiology (N.P.), Moscow, Russia; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Military Institute of Aviation Medicine (D.R.), Warsaw, Poland; Stroke Center (H.K.I.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; and Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom. andrew.smyth@universityofgalway.ie.

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High and moderate alcohol consumption increase stroke risk, while low intake shows no overall association but varies regionally. Heavy episodic drinking is linked to all stroke types.

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Area of Science:

  • Epidemiology
  • Neurology
  • Public Health

Background:

  • Uncertainty exists regarding the association between alcohol consumption and stroke, especially at low to moderate intake levels.
  • The INTERSTROKE study, a large international case-control investigation, aimed to clarify these relationships.

Purpose of the Study:

  • To explore the association between alcohol consumption patterns and the risk of acute stroke.
  • To investigate the impact of different levels and patterns of alcohol intake on stroke subtypes.

Main Methods:

  • Utilized data from the INTERSTROKE study, involving 12,913 cases and 12,935 controls.
  • Alcohol consumption was self-reported and categorized into low, moderate, and high intake levels.
  • Heavy episodic drinking (HED) and multivariable conditional logistic regression were employed to analyze associations.

Main Results:

  • Current drinking was associated with an increased risk of all stroke and intracerebral hemorrhage (ICH), but not ischemic stroke.
  • Heavy episodic drinking (HED) was linked to higher odds of all stroke types, including ischemic stroke and ICH.
  • High and moderate alcohol intake showed consistent associations with increased stroke risk, while low intake had regional variations, decreasing risk in Western Europe/North America and increasing it in India.

Conclusions:

  • High and moderate alcohol consumption are associated with increased stroke risk, whereas low intake is not consistently linked.
  • Significant regional variations in the association between low alcohol intake and stroke were observed.
  • Differences in population characteristics, alcohol types, and consumption patterns may explain the observed regional variations.