Alcohol as a risk factor for stroke
Long term or heavy alcohol drinking increases stroke risk, and can affect people directly and indirectly in many ways by1,2:
- Damaging blood vessels which can result in high blood pressure, increasing the likelihood of blood clots forming, leading to stroke.
- Triggering irregular heartbeats, particularly in susceptible individuals. Atrial fibrillation is one type of irregular heartbeat that can cause blood clots to form in the heart, which may travel to the brain and cause a stroke.
- Leading to cardiomyopathy where the heart muscle weakens and is less effective at pumping blood. This can cause blood clots in the heart, which may travel to the brain and cause a stroke.
- Altering cholesterol levels, leading to an increase in low-density lipoprotein (LDL) cholesterol (‘bad’ cholesterol). High LDL cholesterol levels are a risk factor for atherosclerosis, causing arteries to narrow and increasing the risk of stroke.
- Causing weight gain and an increased risk of developing metabolic syndrome (a cluster of conditions including high blood pressure, high blood sugar, abnormal cholesterol levels and excess abdominal fat) a significant risk factor for cardiovascular diseases, including stroke.
- Having toxic effects on brain cells and blood vessels, making them more vulnerable to damage and increasing the risk of stroke.
In addition, binge drinking (consuming more than eight units a day for men or more than six units a day for women)1,2
- can be particularly dangerous as it can cause blood pressure rise very quickly.
- is associated with a higher risk of pre-hypertension, high blood pressure, heart attack and stroke in middle-aged and older adults.
- may also have adverse cardiovascular effects in young adults (aged 18-30). It may induce oxidative stress and damage to blood vessels.
Alcohol and stroke risk: Key points
High levels of alcohol both directly and indirectly affects stroke risk, but alcohol affects everyone’s health differently. Certain people may have a higher stroke risk at lower levels of alcohol. It often depends on how much drinking impacts on other risk factors, such as blood pressure.
Most health authorities recommend no more than light or moderate drinking and avoiding binge drinking. And, if you do not already drink, it is best not to start.
If you want help to try and drink less or to stop altogether, your family doctor is the best place to start. You may also be able to find addiction support resources and alcohol counselling services in your area.
References
- Mariann R Piano, Adriana Mazzuco, Minkyung Kang, Shane A Philipps, Cardiovasular consequences of binge drinking: An integrative review with implications for advocacy, policy, and research. 2017. Mar;41(3):487-496. https://doi.org/10.1111%2Facer.13329
- Mariann R. Piano, Laurel A. Thur, Tara A. Peters, Andréa Lúcia Gonçalvesa, da Silva, Shane A Phillips. The Effects of Repeated Binge Drinking on Arterial Stiffness and Urinary Norepinephrine Levels in Young Adults. J Hypertens. 2020. Jan38(1):111–117. https://doi.org/10.1097/HJH.0000000000002223