Heavy drinking in middle age increases stroke risk

Heavy may be the head after a hard night of drinking, but research suggests that heavy drinking may also increase stroke risk in middle age, potentially leading to a stroke years earlier than familial or other risk factors may suggest.

Using the “old” cohort of the Swedish Twin registry, researchers looked at what different levels of alcohol consumption meant for stroke risks in patients that had been middle aged in 1960. Pavla Kadlecová, MSc, from the neurology department at St. Anne’s Hospital in Brno, Czech Republic, and colleagues analyzed 43 years of follow-up data. They tabulated questionnaire responses to determine the following groups: nondrinkers, very light drinkers (less than 0.5 drinks per day), light drinkers (between 0.5 and one drink per day), moderate drinkers (between one and two drinks per day), and heavy drinkers (more than two drinks per day). Because nondrinkers included never drinkers and former drinkers, very light drinkers was used as their comparator.

They found that over the course of follow-up, 29 percent of patients had a stroke. Heavy drinkers and nondrinkers had more stroke risk, they found, compared with very light drinkers (hazard ratio 1.34 and 1.11, respectively). For heavy drinkers, alcohol consumption had a greater role in their risk profile than diabetes or hypertension.

Over time, they found that stroke risk increased for nondrinkers, but lessened for heavy drinkers to a point. At age 75, diabetes and hypertension took over for heavy drinkers’ stroke risk. By age 85, however, 88 percent of strokes had already occurred in this category. On average, between pairs of twins, those who were heavy drinkers reduced the time to stroke by 5.68 years compared with their very light drinking counterparts. They found that moderate drinking among women had similar stroke risk as heavy drinking did in male drinkers.

Based on their findings, Kadlecová et al suggested that men should consume no more than two drinks per day and women who were not nursing or pregnant should consume no more than one drink per day. Other studies have suggested some cardioprotective benefit to moderate drinking and the dangers inherent in over consumption. Still others have noted that even moderate consumption may put patients at risk.

“The results imply that alcohol consumption should be considered as a relevant age-dependent risk factor which could have application to studies of younger patients with stroke,” Kadlecová et al wrote.

The study was published online Jan. 29 in Stroke.