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Multicenter Study
. 2025 Jan 16;96(2):114-121.
doi: 10.1136/jnnp-2024-333759.

Association between heavy alcohol consumption and cryptogenic ischaemic stroke in young adults: a case-control study

Nicolas Martinez-Majander  1 , Shakar Kutal  2 , Pauli Ylikotila  3 , Nilufer Yesilot  4 , Lauri Tulkki  2 , Marialuisa Zedde  5 , Tomi Sarkanen  6   7 , Ulla Junttola  8 , Annika Nordanstig  9 , Annette Fromm  10 , Kristina Ryliskiene  11 , Radim Licenik  12 , Phillip Ferdinand  13 , Dalius Jatuzis  11 , Liisa Kõrv  14 , Janika Kõrv  14 , Alessandro Pezzini  15 , Suvi Tuohinen  16 , Juha Sinisalo  16 , Mika Lehto  17 , Eva Gerdts  18   19 , Essi Ryödi  20 , Jaana Autere  21 , Marja Hedman  22 , Ana Catarina Fonseca  23 , Ulrike Waje-Andreassen  10 , Bettina von Sarnowski  24 , Petra Redfors  9 , Tiina Sairanen  2 , Turgut Tatlisumak  9 , Risto O Roine  3 , Juha Huhtakangas  8 , Heikki Numminen  6 , Pekka Jäkälä  21 , Jukka Putaala  2 ; SECRETO Study Group
Affiliations
Multicenter Study

Association between heavy alcohol consumption and cryptogenic ischaemic stroke in young adults: a case-control study

Nicolas Martinez-Majander et al. J Neurol Neurosurg Psychiatry. .

Abstract

Background: The underlying risk factors for young-onset cryptogenic ischaemic stroke (CIS) remain unclear. This multicentre study aimed to explore the association between heavy alcohol consumption and CIS with subgroup analyses stratified by sex and age.

Methods: Altogether, 540 patients aged 18-49 years (median age 41; 47.2% women) with a recent CIS and 540 sex-matched and age-matched stroke-free controls were included. Heavy alcohol consumption was defined as >7 (women) and >14 (men) units per week or at least an average of two times per month ≥5 (women) and ≥7 (men) units per instance (binge drinking). A conditional logistic regression adjusting for age, sex, education, hypertension, cardiovascular diseases, diabetes, hypercholesterolaemia, current smoking, obesity, diet and physical inactivity was used to assess the independent association between alcohol consumption and CIS.

Results: Patients were twice as more often heavy alcohol users compared with controls (13.7% vs 6.7%, p<0.001), were more likely to have hypertension and they were more often current smokers, overweight and physically inactive. In the entire study population, heavy alcohol consumption was independently associated with CIS (adjusted OR 2.11; 95% CI 1.22 to 3.63). In sex-specific analysis, heavy alcohol consumption was associated with CIS in men (2.72; 95% CI 1.25 to 5.92), but not in women (1.56; 95% CI 0.71 to 3.41). When exploring the association with binge drinking alone, a significant association was shown in the entire cohort (2.43; 95% CI 1.31 to 4.53) and in men (3.36; 95% CI 1.44 to 7.84), but not in women.

Conclusions: Heavy alcohol consumption, particularly binge drinking, appears to be an independent risk factor in young men with CIS.

Keywords: STROKE.

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Conflict of interest statement

Competing interests: JP: shareholder of Olvi Oyj. TT: has served/serves on scientific advisory boards for Astra Zeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Inventiva and Portola Pharm.

Figures

Figure 1
Figure 1. Comparison of heavy alcohol consumption for all study participants and stratified by sex and age group.
Figure 2
Figure 2. Association between heavy alcohol consumption and cryptogenic ischaemic stroke, stratified by sex and age (for men only). Diabetes and cardiovascular disease included in the model only in older men (45–49 years) due to low prevalence of these risk factors in other groups.
Figure 3
Figure 3. Comparison of binge drinking for all study participants and stratified by sex and age group.
See this image and copyright information in PMC

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