Tulane University researchers found that heavy drinking -- more than 21 drinks per week -- may increase the risk of stroke. The results of the study of a large group of men in China are published in a recent issue of Annals of Neurology.

"We found that the men who drink more, especially at the higher levels of alcohol consumption, have a much higher risk of stroke," says Lydia Bazzano, assistant professor of epidemiology at the Tulane School of Public Health and Tropical Medicine. A team led by Bazzano examined the relationship between alcohol consumption and stroke in a large, nationally representative sample of Chinese men.

"The relationship between alcohol intake and the development of stroke has not been very clear from observational studies done in the past," says Bazzano. "We wanted to look at this relationship in a really large cohort, which gives us the best power to detect any association. And stroke is the No. 1 killer of men in China, so it was also very interesting to look at it there in particular."

China has a different stroke distribution than some other countries, so the study applies best to Asian males, according to Bazzano. "But because we know something about the way alcohol may be related to the development of stroke, it probably is applicable to just about everyone," she says. "We know that heavy alcohol consumption can induce hypertension, and hypertension -- high blood pressure -- is the No. 1 risk factor for a stroke of any type."

The research team conducted a follow-up study focusing on 64,338 men who participated in the 1991 China National Hypertension Survey. The original study involved approximately 180,000 people from 17 different provinces throughout China. At the start of the 1991 survey, all of the men were more than 40 years old and free of stroke. They provided information about their demographic characteristics, medical history and lifestyle risk factors, including alcohol consumption.

Between 1999 and 2000, the researchers followed up with male participants of the original study who had provided information on alcohol consumption. The investigators examined all incidents of stroke in the group since 1991 and assessed any relationship between alcohol consumption and stroke.

Public health education to prevent alcohol abuse and actions to help alcohol abusers decrease their alcohol intake are important steps for reducing stroke rates in all countries, says Bazzano.

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