A study by Dr Laura Sundell and colleagues of National Public Health Institute (KTL), Helsinki, Finland states that heavy alcohol consumption increases the risk for all strokes, whereas moderate regular alcohol consumption is associated with a lower risk for ischemic stroke. The purpose of their recent study was to evaluate the effect of different drinking patterns on stroke risk, independent of average alcohol intake. A prospective cohort study of 15,965 Finnish men and women age 25 to 64 years who participated in a national risk factor survey and had no history of stroke at baseline were followed up for a 10-year period. The first stroke event during follow up served as the outcome of interest (N=249 strokes). A binge drinking pattern was defined as consuming 6 or more drinks of the same alcoholic beverage in men or 4 or more drinks in women in 1 session. Cox proportional-hazards models were adjusted for average alcohol consumption, age, sex, hypertension, smoking, diabetes, body mass index, educational status, study area, study year, and history of myocardial infarction.
Results show that binge drinking was an independent risk factor for total and ischemic strokes. Compared with nonbinge drinkers, the hazard ratio for total strokes among binge drinkers was 1.85 (95% CI, 1.35 to 2.54) after adjusting for average alcohol consumption, age, and sex; the association was diluted after adjustment for other risk factors. Compared with nonbinge drinkers, the risk for ischemic stroke was 1.99 (95% CI, 1.39 to 2.87) among binge drinkers; the association remained statistically significant after adjustment for potential confounders. The authors conclude that a pattern of binge drinking is an independent risk factor for all strokes and ischemic stroke.
Professor R Curtis Ellison comments: ‘This study from Finland was on a population-based prospective study of more than 15,000 subjects, including about 650 “heavy drinkers” (defined as > 350g of alcohol/week for men and > 210g of alcohol/week for women). Despite the rather large number of heavy drinkers, there was no relation between average alcohol intake and the risk of total stroke (n=249) or ischemic stroke (n=179) during an average follow up 9 to 10 years.
On the other hand, among ‘binge drinkers’ (men consuming more than 5 drinks/occasion of a beverage or women consuming more than 3 drinks/occasion of a beverage), the risk of total and ischemic stroke was 40 to 60% higher than it was for drinkers who did not report binge drinking, even with adjustment for average long-term intake. There were only 70 subjects with hemorrhagic stroke; no association with binge drinking was seen’.
Source: Sundell L, Salomaa V, Vartiainen E, Poikolainen K, Laatikainen T. Increased stroke risk is related to a binge drinking habit. Stroke 2008;39:3179-3184.