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Heavy drinkers may risk brain bleed at a young age

People who drink heavily may be at risk of suffering a brain haemorrhage at a relatively early age, researchers reported. Heavy drinking has long been considered a risk factor for stroke.

In the new study, French researchers focused on drinking habits among 540 people who'd suffered an intracerebral haemorrhage. A quarter of them were heavy drinkers before the stroke, consuming the equivalent of at least four drinks per day.

Their brain haemorrhage typically struck at the age of 60, versus age 74 among patients who were not heavy drinkers, the researchers reported in Neurology."Chronic heavy alcohol intake increases the risk of bleeding at a very young age," senior researcher Dr Charlotte Cordonnier said.

What the study found

Heavy drinkers were not only younger when they had their brain haemorrhage - they were also relatively healthy, added Dr 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.

Smoking is not necessarily to blame for the earlier strokes, however. "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 42% of heavy drinkers in the study were smokers, compared to 12% of the 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 Dr Goldstein. Besides suffering brain haemorrhages at a younger age, some of the big drinkers in this study also had a worse prognosis.

When the stroke was nonlobar, 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. Platelet counts and prothrombin ratio were significantly lower among heavy alcohol drinkers.

"Heavy alcohol intake is associated with the occurrence of ICH at a young age," the authors concluded. "However, the underlying vasculopathy remains unexplored in these patients. Indirect markers suggest small-vessel disease at an early stage that might be enhanced by moderate hemostatic disorders."

(Reuters Health, Amy Norton, September 2012)

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