(Refer to relevant sections for Class and Levels of Evidence for each recommendation.) Alcohol Consumption The National Institute on Alcohol Abuse and Alcoholism defines heavy drinking for a man as >4 drinks in any single day or >14 drinks per week and defines heavy drinking for a woman as >3 drinks any single day and >7 drinks per week.660 A standard drink is defined as 12 fl oz of regular beer, 5 fl oz of table wine, or a 1.5 fl oz shot of 80-proof spirits. Heavy alcohol consumption can lead to multiple medical compli- cations, including stroke. Heavy alcohol consumption is a risk factor for all types of stroke.661 665 Most studies suggest a J-shaped association between alcohol consumption and the risk of total and ischemic stroke, with a protective effect in light (<151 g/wk) or moderate (151 to 300 g/wk) drinkers and an elevated risk with heavy (>300 g/wk) alcohol consump- In contrast, a linear association exists between alcohol consumption and the risk of ICH.330,334,677,678 In a pro- spective cohort study of 540 patients with spontaneous ICH,679 heavy alcohol intake was associated with ICH at a young age (median age, 60 versus 74 years in nonabusers; P<0.001). Light-to-moderate alcohol consumption is associated with higher levels of HDL cholesterol,680,681 reduced plate- lower fibrinogen concentrations,684 and increased insulin sensitivity and glucose metabolism.685,686 Heavy alcohol consumption can result in hypertension,687 693 hypercoagulability, reduced cerebral blood flow,694 and an increased risk of AF.662,668,695 698 Studies show an increased risk for stroke in hypertensive patients who consume alco- hol, as well as poor BP control in heavy drinkers with hypertension. 