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. A study of 43685 men from the Health Professionals Follow-Up Study and 71243 women from the Nurses Health Study showed that alcohol intake had a J-shaped associa- tion for risk of stroke.667 A lower risk for stroke was found in women who were light drinkers, but women who drank 30 g alcohol per day had a 40% increased risk for stroke (RR, 1.41; 95% CI, 1.07 1.88 for ischemic stroke; RR, 1.40; 95% CI, 0.86 2.28 for ICH). There was a similar but nonsig- nificant pattern for men. In the WHS,699 alcohol consumption was not associated with risk for stroke, even for 10.5 drinks per week. However, a recent meta-analysis showed a higher mortality risk for women compared with men who drank >3 drinks per day.700 A prospective study of Chinese men701 supports the associa- tion between heavy alcohol and risk for stroke.A 22% increase in stroke occurred for those consuming at least 21 drinks per week, whereas consumption of 1 to 6 drinks per week was associated with the lowest risk. In a meta-analysis of 35 obser- consumption of 60 g alcohol per day was associated with a 64% increased risk for all stroke (RR, 1.64; 95% CI, 1.39 1.93), a 69% increase for ischemic stroke (RR, 1.69; 95% CI, 1.34 2.15), and more than doubling for hemor- rhagic stroke (RR, 2.18; 95% CI, 1.48 3.20). 