Stroke Risk Rises for Young People Who Drink Frequently
Cumulative effect seen with 2 or more years of moderate-to-heavy drinking
By Judy George, Deputy Managing Editor
November 2, 2022
People in their 20s and 30s who were moderate-to-heavy drinkers were more likely to have a stroke in early adulthood compared with those who consumed low amounts of alcohol each week, Korean national database records showed.
Young adults who consumed 105 g of alcohol per week, or 15 g per day, for 2 or more years were more likely to have a stroke over 5.6 years of follow-up versus light drinkers (HR 1.19, 95% CI 1.05-1.34, P<0.001), reported Eue-Keun Choi, MD, PhD, of Seoul National University in the Republic of Korea, and co-authors in Neurology.
Stroke risk rose as the number of years of moderate-to-heavy drinking in young adulthood increased. At 3 years, the adjusted HR was 1.22 (95% CI 1.09-1.38), and at 4 years, it was 1.23 (95% CI 1.10-1.38; both P<0.001).
A standard drink in the U.S. contains about 14 g of alcohol, equivalent to 12 oz of beer, 5 oz of wine, or 1.5 oz of liquor.
“The rate of stroke among young adults has been increasing over the last few decades, and stroke in young adults causes death and serious disability,” Choi said in a statement.
“Since more than 90% of the burden of stroke overall can be attributed to potentially modifiable risk factors including alcohol consumption, and since stroke in young adults severely impacts both the individual and society by limiting their activities during their most productive years, reducing alcohol consumption should be emphasized in young adults with heavy drinking habits as part of any strategy to prevent stroke,” he added.
Choi and colleagues assessed people ages 20 to 29 (mean age 29.5) from the Korean National Health Insurance Service database who had four consecutive annual health exams from 2009 to 2012.
Participants self-reported alcohol consumption at the exams. The researchers calculated a cumulative alcohol burden score by assigning a score of 1 for each year weekly alcohol consumption was reported at 105 g or more. Burden scores ranged from 0 (no years with weekly alcohol consumption at 105 g or more) to 4 (signifying 4 years with weekly alcohol consumption at 105 g or more).
“The proportion of males was overwhelmingly high with high cumulative alcohol burden, reaching approximately 95% in group 4,” Choi and co-authors observed. “Mean blood pressure, body mass index, obesity, waist circumference, central obesity, fasting glucose, total cholesterol, and triglyceride levels tended to increase as the cumulative alcohol burden increased.”
Overall, 1,536,668 young people were included in the assessment; 71.5% were men. Over a mean follow-up of 5.6 years, 3,153 people experienced an incident stroke (incidence rate 0.37 per 1,000 person-years).
Both incidence rates and hazard rates increased steadily as cumulative years of moderate-to-heavy drinking increased.
“This positive dose-response relationship was primarily driven by hemorrhagic rather than ischemic stroke,” Choi and co-authors wrote. Compared with a cumulative alcohol burden score of 0, the HR for hemorrhagic stroke was 1.30 for a burden score of 2, 1.42 for a score of 3, and 1.36 for a score of 4.
The overall study population was Korean, which is a limitation of the study, the authors noted. In addition, people who did not receive four consecutive annual health examinations were excluded. Alcohol use was self-reported and subject to recall bias.