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Vicki A. Jackson, MD; Howard D. Sesso, ScD; Julie E. Buring, ScD; J. Michael Gaziano, MD

Arch Intern Med. 2003;163:1189-1193.

Background  In counseling patients with a history of stroke, clinicians have limited information regarding the risks and benefits of alcohol consumption.

Objective  To examine the relationship between alcohol intake and risks of total and cardiovascular mortality in men with a history of stroke.

Methods  The study population consisted of 112 528 men from the enrollment cohort of the Physicians' Health Study, 1320 of whom reported a baseline history of stroke. Men provided self-reported data on alcohol consumption, which was classified into 1 of 4 categories: rarely or never drink, very light (<1 drink per week), light (1-6 drinks per week), or moderate (1 drink per day). Cox proportional hazards models were used to assess the relative risks of mortality associated with alcohol consumption, after adjustment for major coronary risk factors.

Results  During a mean follow-up of 4 years, 369 men died, 267 of whom died of cardiovascular disease. Compared with men with a history of stroke who drank rarely or never, those with a very light to moderate alcohol intake had multivariate relative risks for total mortality of 0.88 (95% confidence interval [CI], 0.60-1.28), 0.64 (95% CI, 0.48-0.85), and 0.71 (95% CI, 0.54-0.94), respectively (P = .03 for trend); and relative risks for cardiovascular mortality of 0.89 (95% CI, 0.58-1.36), 0.56 (95% CI, 0.40-0.79), and 0.64 (95% CI, 0.46-0.88) P = .008 for trend). Compared with age-adjusted models, adjustment for major coronary risk factors did not significantly change risk estimates for total or cardiovascular mortality.

Conclusions  These data indicate a possible inverse association between light to moderate alcohol intake and risks of total and cardiovascular mortality in men with a history of stroke. More data are needed to confirm or refute these results.

From the Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System (Drs Jackson, Sesso, and Gaziano); Preventive Medicine Division (Drs Sesso, Buring, and Gaziano) and Cardiovascular Division (Dr Gaziano), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Department of Epidemiology, Harvard School of Public Health (Drs Sesso, Buring, and Gaziano); and Department of Ambulatory Care and Prevention, Harvard Medical School (Dr Buring); Boston, Mass. Dr Jackson is now affiliated with Dana-Farber Cancer Institute, Boston. The authors have no relevant financial interest in this article.

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