Alcohol use and types and ischemic stroke: a systematic review and meta-analysis.

Objective: This systematic review and meta-analysis was conducted to investigate the association between alcohol use pattern and ischemic stroke risk.

Methods: We searched PubMed, Scopus, Web of Sciences, Embase and CENTRAL up to the 1st of June, 2024. Studies were included if they were articles that assessed the impact of alcohol drinking pattern on the risk of ischemic stroke. The random effect model was utilized to combine the results. Data analysis was performed using Meta XL, version 5.3.

Results: The total number of included participants was 21,293,471 from 125 studies. The model that investigated the association between light alcohol use and ischemic stroke risk showed no association [relative risk (RR) =0.97, 95% confidence interval (CI) 0.89-1.05]. Moderate alcohol use was associated with significant decrease in ischemic stroke risk (RR=0.87; 95% CI 0.83-0.92) while heavy alcohol use was associated with significant increase in ischemic stroke risk (RR=1.31; 95% CI 1.19-1.44). Sub-group analysis among males showed results similar to the primary analysis while among females, only moderate alcohol drinking was significantly associated with ischemic stroke (RR=0.50; 95% CI 0.33-0.75). Moderate and heavy wine use was associated with significant reduction in ischemic stroke risk (RR=0.61; 95% CI 0.45-0.84¸ RR=0.77; 95% CI 0.63- 0.93).

Conclusions: Our analysis provided a strong and robust evidence that there was a significant association between moderate and heavy alcohol use with ischemic stroke risk. However, this association varied by several variables including type of alcohol with the effect being more protective among people who use wine. This study was registered in PROSPERO (CRD42023437946).