Abstract

According to the seventh edition of Webster’s New Collegiate Dictionary , the definition of labyrinth is “something extremely tortuous or complex in structure, arrangement, or character.” The investigator who studies the relations of alcohol drinking to stroke chooses a tortuous path. Multiple issues need consideration. (1) Stroke is not one disease. There are disparities in risk factors of the major stroke types, hemorrhagic stroke (HS), and ischemic stroke (IS), and of their subdivisions.1–5 (2) Several cardiovascular conditions have independent relations to alcohol drinking and also to ≥1 stroke types; these include systemic hypertension (HTN), dilated cardiomyopathy, atrial arrhythmias, and coronary heart disease.6,7 (3) As always with respect to alcohol, light-moderate and heavy drinking play quite different roles. (4) Cigarette smoking, a strong adverse predictor of HS and IS, is correlated with alcohol drinking and must be carefully controlled. (5) Drinking pattern and beverage choice play a role; binge drinking, in particular, increases risk.1 (6) Drinking habits change. (7) Nonalcohol components of specific beverages might play a role. (8) There are potential interactions of alcohol with antithrombotic …

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