Heavy drinkers may risk brain bleed at a young age
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NEW YORK - People who drink heavily may be at risk of suffering a brain hemorrhage at a relatively early age, researchers reported Monday.
Heavy drinking has long been considered a risk factor for stroke.
In the new study, French researchers focused on drinking habits among people who'd suffered an intracerebral hemorrhage - a type of stroke where ruptured blood vessels leak blood into the brain. It accounts for 10 percent of the 800,000 strokes per year in the US.
Among the 540 patients they followed, one-quarter were heavy drinkers before the stroke - downing the equivalent of at least four drinks per day.
And their brain hemorrhage typically struck at the age of 60, versus age 74 among patients who were not heavy drinkers, the researchers report in the journal Neurology.
"Chronic heavy alcohol intake increases the risk of bleeding at a very young age," senior researcher Dr. Charlotte Cordonnier said in an email.
Heavy drinkers were not only younger when they had their brain hemorrhage - they were also relatively healthy, added Cordonnier, of the University of Lille Nord de France.
Compared with patients who were not heavy drinkers, they were less likely to have any history of heart disease, stroke or "mini-stroke" symptoms.
No proof of cause-effect
A neurologist not involved in the study said the findings cannot prove that heavy drinking, itself, leads to brain hemorrhage at an early age.
"There may be other things these individuals were doing that would affect their risk," said Dr. Larry B. Goldstein, director of the Duke Stroke Center in Durham, North Carolina, and a spokesperson for the American Heart Association/American Stroke Association.
He pointed out that heavy drinkers in the study were often smokers: 42 percent were, versus 12 percent of other patients.
And there could have been other, unmeasured differences between heavy drinkers and people who drank moderately or not at all.
Still, the findings are in line with what's known about alcohol and stroke risk, and there are reasons to believe that heavy drinking, itself, is the problem, according to Goldstein.
The habit can feed high blood pressure, a known risk factor for stroke. It may also affect the blood's ability to clot, which could raise the odds of a hemorrhage-type stroke.
And in this study, heavy drinkers had lower levels of certain substances that allow blood to clot - though those levels were still within normal range.
The bottom line, according to Goldstein, is that moderation is the way to go.
"Excessive alcohol consumption is bad for your brain, in a number of ways," he said.
In general, experts recommend that women have no more than one alcoholic drink per day, while men should limit it to two.
In contrast to what's seen with heavy drinking, studies have linked such moderate drinking to a lower risk of heart disease and possibly stroke as well. But it's not certain that the alcohol deserves the credit.
"You shouldn't start drinking to try to get health benefits," Goldstein stressed.
Besides suffering brain hemorrhages at a younger age, some of the big drinkers in this study also had a worse prognosis.
When the stroke occurred in a deep part of the brain, heavy drinkers younger than 60 were more likely to die within two years, versus other patients their age. More than half died, compared with about a third of those who did not drink heavily.
When the researchers accounted for certain other factors, like smoking habits, the heavy drinkers were twice as likely to die.
Again, it's not clear that people's past drinking habits were the reason, since the study could not account for all the potential differences between heavy drinkers and moderate ones.
But the message on drinking remains the same, Goldstein said.