HEAVY alcohol consumption, particularly binge drinking, is independently associated with cryptogenic ischaemic stroke (CIS) in young men.
Young-onset cryptogenic ischaemic stroke (CIS) has unclear underlying risk factors, making prevention and early intervention challenging. This multicentre case-control study aimed to explore the link between heavy alcohol consumption and CIS in adults aged 18–49. Given the increasing prevalence of stroke in younger populations and the potential for modifiable lifestyle factors to contribute to risk, understanding this relationship is crucial for clinical practice and public health.
The study included 540 patients with recent CIS and 540 age- and sex-matched stroke-free controls. Heavy alcohol consumption was defined as exceeding seven (women) or 14 (men) units per week or engaging in binge drinking at least twice a month. Conditional logistic regression, adjusting for relevant cardiovascular and lifestyle factors, was used to assess the independent association between alcohol consumption and CIS. Results showed that heavy alcohol consumption was significantly more prevalent among CIS patients (13.7%) than controls (6.7%, p<0.001). Adjusted analysis confirmed a strong independent association between heavy alcohol consumption and CIS (adjusted OR 2.11; 95% CI 1.22 to 3.63). This association was particularly pronounced in men (OR 2.72; 95% CI 1.25 to 5.92) but not statistically significant in women (OR 1.56; 95% CI 0.71 to 3.41). Binge drinking alone also showed a significant association with CIS in the overall cohort (OR 2.43; 95% CI 1.31 to 4.53) and in men (OR 3.36; 95% CI 1.44 to 7.84), but not in women.
These findings highlight heavy alcohol consumption, especially binge drinking, as a modifiable risk factor for CIS in young men. While the association was not significant in women, further research is needed to determine potential sex-specific mechanisms. Clinicians should prioritise alcohol screening and lifestyle counselling in young adults at risk of stroke, emphasising the dangers of excessive alcohol intake. Future studies should explore the biological and behavioural pathways underlying these findings and assess the effectiveness of targeted interventions to mitigate risk.
Katrina Thornber, EMJ
Reference
Martinez-Majander N et al. Association between heavy alcohol consumption and cryptogenic ischaemic stroke in young adults: a case–control study. Journal of Neurology, Neurosurgery & Psychiatry. 2025;96:114-21.
