Beer Marketer's Insights - More Severe Strokes Linked to Heavy, But Not Moderate Drinking, Study Shows

Heavy drinkers, but not light or moderate drinkers, may experience more severe strokes or brain bleeds at younger ages compared to all others, a new paper published this month suggests. Both the study itself and the modest news coverage it received emphasized the increased stroke risk linked to "excessive" or "heavy alcohol use" (HAU), categorized here as an average of 3 or more drinks per day. Indeed, though they looked for it, researchers found no significant increase in risk, nor any consistent pattern to outcomes, among patients reporting lower levels of alcohol consumption. Yet one of the study's lead authors still chose to caution patients that "limiting alcohol consumption to no more than three drinks per week may be an effective measure to protect against all types of stroke." Ref 1 Clear Results Among Small Sample of Heavy Drinkers The study is based on data for 1,600 patients of Massachusetts General Hospital between 2003 and 2019, all admitted with a brain bleed or stroke that wasn't the result of "an injury or trauma" (like a car accident). Based on prior research linking heavy alcohol consumption with more severe stroke symptoms and outcomes, researchers compared patients who reported HAU (or whose family-member reported it for them) to everyone else. The former group turned out to be quite small, at just over 100 or just 6.5% of the sample (more on this later).The results were clear. Patients in the HAU group were significantly more likely to be younger, showing an average age of 64 at time of admission compared to an average age of 75 for everyone else. Heavy drinkers were also more likely to have more severe bleeding in deeper brain regions, generally experiencing more intense strokes that were harder to treat and required longer hospital stays. Consequently, while patients reporting HAU were more likely to be independent and not require the assistance of others at the time of admission, they were more likely to transition to dependence after their stroke.Results for Light, Moderate Drinking Inconclusive Since they had the data, researchers also ran results for lower levels of consumption, including for infrequent drinkers (less than 1 drink per week) and light to moderate drinkers (1 or 2 drinks per day). But "no significant associations were observed for intermediate levels of alcohol consumption (<3 drinks per day) except for age." That is, stroke patients reporting an average of 2 drinks per day also tended to be significantly younger than non-drinkers.But no other significant results appeared. In fact, for key measures, results were anything but linear, with risk curves rising and falling in sometimes irregular patterns. Some measures turned out equally better for infrequent as well as light-moderate drinkers, while other results looked better for isolated groups. Infrequent drinkers and abstainers did not always show the "healthiest" outcomes. Broadly, results varied widely among each of the groups of drinkers, as well. In short, below the threshold categorized here as "heavy" drinking, these researchers could not identify a meaningful relationship between alcohol consumption and stroke risk, symptoms or outcomes.Of Sample Sizes and Confounders The relatively small sample sizes among drinkers likely contributed to the above results. Recall, the heavy drinking group was small and so were the others. Researchers tallied just 251 infrequent drinkers, 107 patients who reported 1 drink per day and just 42 reporting 2/day, less than 16%, 7% and 3% of the sample, respectively. So almost 1,100, or 68.5% of the sample reported abstention. That's the reverse of the norm, where upwards of 2/3 of the population report any alcohol consumption (especially in a sample like this one that is less racially diverse).Read into that as you wish, but consider the impact of age and other potential confounders as well. In addition to being younger, heavier drinking stroke patients were also more likely to smoke and have liver disease. But otherwise, the group appeared healthier, with generally fewer cases of heart disease and diabetes, or using medicine to treat such chronic diseases. Again, the average age of this non-HAU group was 75, suggesting many of these patients, of which an even larger portion were abstainers, were already in their upper 70s to 80s at the time of their strokes, ages when alcohol consumption is generally less likely. And importantly, patients were not asked about their lifetime history of alcohol use, only if they ever consumed an average of 5+ drinks per day for a year or more. Such individuals were only excluded from the non-HAU group.Cheers,References1 Gurol, ME, Hindsholm, MF, et al, "Effects of Heavy Alcohol Use on Acute Intracerebral Hemorrhage and Cerebral Small Vessel Disease," Neurology, November 2025

More Severe Strokes Linked to Heavy, But Not Moderate Drinking, Study Shows

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