Alcohol Boosts Stroke Risk More Than Do Hypertension, Diabetes

January 29, 2015

Drinking more than two alcoholic beverages a day in middle-age raises stroke risk in early old age more than do traditional risk factors, such as high blood pressure and diabetes, a new study suggests.

The study is published online January 29 in Stroke, with first author Pavla Kadlecová, MSc, St. Anne's Hospital, Brno, Czech Republic.

The study found that individuals who consumed more than two drinks a day during midlife had double the risk for stroke between the ages of 60 and 75 years compared with those who consumed an average of half an alcoholic drink per day.

A similar analysis of stroke risk associated with hypertension and diabetes found that heavy drinking during midlife was a more important risk factor for strokes occurring before age 75. But stroke risk after age 75 was more affected by diabetes and hypertension than was earlier alcohol consumption.

Previous studies have shown that alcohol affects stroke risk, but this is the first study to pinpoint differences with age, the authors note.

Pavla Kadlecová

Kadlecová commented to Medscape Medical News: "Individuals consuming more than 2 alcoholic drinks per day are putting themselves at a significantly increased risk of stroke, particularly in their early old age, when they should still be active and productive."

Doctors: Ask About Alcohol Intake

"Doctors should be paying attention to alcohol consumption in middle-aged patients as much as conditions such as hypertension and diabetes, which are well known to increase stroke risk," she added.

For the study, the researchers analyzed data from a large Swedish registry of twins born between 1886 and 1925. This included a total of 11,644 people who were asked about their alcohol intake at age 45 to 55 years. They were categorized as light, moderate, or heavy drinkers or nondrinkers on the basis of the questionnaires.

The incidence of stroke, which occurred in almost 30% of participants, was identified from hospital discharge and cause-of-death registries during a 43-year follow-up.

After accounting for confounders, including baseline age, sex, cardiovascular diseases, diabetes mellitus, stress reactivity, depression, body mass index, smoking, and exercise, the stroke rate was lowest in the very light drinkers: those who drank an average of less than half an alcoholic drink per day.

Compared with this group, heavy drinkers — those who consumed an average of more than two drinks per day — had a 34% increased risk for stroke during the whole follow-up period (hazard ratio, 1.34; P = .02). In addition, this group had a doubling in the risk for stroke in early old age (age 60 to 75 years).

Nondrinkers had a small increased risk for stroke vs very light drinkers, which approached significance (hazard ratio, 1.11; P = .08).

Risk for stroke associated with alcohol consumption in midlife and with other risk factors as functions of age. (©2015 American Heart Association, Inc.)

In another analysis of 167 identical twin pairs in which both twins had a stroke, the individuals who consumed more than two drinks a day experienced the stroke an average of 5 years earlier than those who drank very lightly.

This study was supported by the European Regional Development Fund. The authors have disclosed no relevant financial relationships.

Stroke. Published online January 29, 2015. Abstract

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