Heavy drinkers may be at a much greater risk for a bleeding stroke, a new study suggests.

People who drank about three or more alcoholic drinks per day also had the strokes almost a decade and a half before those who didn’t drink quite as much. The findings appear in Neurology.

Exactly how heavy drinking may raise risk of this type of stroke is not clear.

The study included 540 French people with an average age of 71 who had a less common type of stroke called an intracerebral hemorrhage. This type of stroke is caused by bleeding in the brain, not a blood clot. 

The people in the study and/or their caregivers or relatives were asked about drinking habits. Fully 25% were heavy drinkers. This was defined as having about three or more drinks per day, or about 1.8 ounces per day of “pure” alcohol.  Participants also had CT scans of their brains, and French researchers reviewed their medical records.

The heavy drinkers were about 60 when they had stroke. By contrast, the people who were not heavy drinkers were about 74 when they had a stroke. The heavy drinkers were also more likely to be smokers and did show some evidence of irregularities in their blood that would make them more likely to have a bleeding stroke.

One Drink a Day Is Still OK

“The study does add to our knowledge that excessive drinking is bad for our health in a variety of ways, including increased risk of bleeding into the brain,” says Deepak L. Bhatt, MD, MPH. He is a heart doctor at Brigham and Women's Hospital in Boston and an associate professor at Harvard Medical School.

Still, the study is small, and larger ones will be needed before telling people not to drink past a certain level.

Heavy drinkers may be more likely to have high blood pressure, which is a major risk factor for stroke. “If someone enjoys drinking, I don’t discourage them, but I will caution them even more so after this study to make sure that the amount is considered moderate,” Bhatt says.

Risks of falling and liver problems are also linked to heavy drinking, he says.

However, “we do know that one glass of red wine a day, on average, lowers heart attack and stroke risk, and that is still true," says Patrick Lyden, MD. He is the chair of the department of neurology at of Cedars-Sinai Medical Center in Los Angeles.

His advice remains unchanged. “If you don’t drink, don’t start because you think it will protect your heart, and if you do drink, keep it moderate.”

So what is moderate drinking, exactly?  “My rule of thumb is one glass of wine a night, and that is the same as a glass of beer or one mixed drink,” he says. “This doesn’t mean you can save them up and have seven drinks on a Saturday.”

Certain people should avoid alcohol, including those taking blood thinners and people with high blood pressure, Lyden adds.

Rafael Ortiz, MD, is the director of the Center for Stroke and Neuro-Endovascular Surgery at Lenox Hill Hospital in New York City. He tells WebMD that smart stroke prevention includes:

• Not smoking
• Eating a healthy diet
• Maintaining normal blood pressure levels
• Moderate drinking

“These are concrete things we can all do today to lower our risk of stroke,” he says.

SOURCES: Casolla, B. Neurology, 2012, study received ahead of print.Deepak L. Bhatt, MD, MPH, cardiologist, Brigham and Women's Hospital; associate professor, Harvard Medical School, Boston.Patrick Lyden, MD, chair, department of neurology, Cedars-Sinai Medical Center, Los Angeles.Rafael Ortiz, MD, director, Center for Stroke and Neuro-Endovascular Surgery, Lenox Hill Hospital, New York City.

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