Heavy drinking is tied to earlier and more severe brain bleeds, a new study found. The paper, published Wednesday in the journal Neurology, examined the link between alcohol and intracerebral hemorrhages — the deadliest, most disabling type of stroke.
The researchers found that so-called heavy drinkers — people who had three or more drinks per day — developed a stroke on average 11 years earlier than those who had fewer than three drinks per day. They also had larger brain bleeds that were more difficult to manage.
This data cannot prove that alcohol led to earlier, more severe brain bleeds. But it aligns with a wide body of research linking heavy alcohol use to damaged blood vessels and cardiovascular disease.
“Alcohol in high doses is toxic to brain cells,” said Dr. Bruce Ovbiagele, a professor of neurology at the University of California, San Francisco, who was not involved with the study.
About 85 percent of strokes are caused by blockages in the brain — usually from blood clots — and research has largely focused on the relationship between alcohol and these types of strokes, called ischemic strokes. Intracerebral hemorrhages, on the other hand, are caused by a blood vessel bursting and bleeding into the brain.
The researchers looked at 1,600 patients with brain bleeds who were treated at Massachusetts General Hospital between 2003 and 2019. Alcohol use was recorded at the hospital, either by the patient, a friend or a family member. The researchers also analyzed brain M.R.I. scans, which were available for 75 percent of the patients.
Heavy drinkers had higher blood pressures and lower amounts of blood-clotting cells, both of which are tied to the risk and severity of brain bleeds. Their scans suggested that the tiny blood vessels in the brains of heavy drinkers were more brittle, stiff and leaky than in those who drank less, said Dr. Edip Gurol, a neurologist at Massachusetts General Hospital who led the study.
Heavy drinkers were also three times more likely to show signs of brain aging, specifically damage to the brain’s white matter. And heavy drinkers were over 90 percent more likely to lose their independence after a stroke — for example needing help to dress, bathe or get around — upon leaving the hospital.
The study also found that people who had two drinks per day developed brain bleeds at younger ages compared with people who don’t drink.
While doctors can pull out blood clots in the brain or dissolve them with drugs, little can be done for a brain bleed, Dr. Gurol said.
“It’s almost like a bomb exploding in the brain,” he added; doctors can try to limit further harm but can’t undo the damage.
That’s why trying to prevent strokes is so important, especially for people with existing risk factors like high blood pressure, Type 2 diabetes, obesity, smoking and heavy drinking, Dr. Ovbiagele said.
More research is needed to fully understand how alcohol affects brain health. The researchers in this study asked patients only about current drinking habits and couldn’t assess lifetime drinking habits, said Dr. Amytis Towfighi, the chief of neurology at Los Angeles General Medical Center. And drinking may have been underreported.
The data was also based on a single hospital, and more than 85 percent of the patients in the study were white, Dr. Towfighi said. It’s not clear whether other areas and populations would produce the same results.
This research comes at a time when drinking rates have dropped to new lows in the United States, as experts emphasize that no amount of alcohol improves health.
The occasional drink is probably fine, Dr. Gurol said. But experts say you should limit alcohol intake to potentially reduce stroke risk and ward off other health issues.
Simar Bajaj covers health and wellness.
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