Abstract 13797: Does Alcohol Consumption Have a Cumulative Effect on the Risk of Stroke in Young Adults?

Backgrounds: Alcohol consumption is one of the major and modifiable risk factors for stroke in young people. There is a paucity of information regarding the risk of drinking on stroke development, especially in young adults. We investigated the effect of alcohol consumption on the risk of stroke and its subtypes in young adults. Methods: Using the Korean National Health Insurance Service database, a total of 1,523,299 subjects aged between 20 and 39 were identified, who underwent 4 consecutive annual health examinations between 2009 and 2012, with no history of stroke, myocardial infarction, and congestive heart failure. At each annual health examination, the alcohol consumption of the subjects was divided into non, mild (>0 and <105g/week), moderate (≥105g and <210g/week), and heavy (≥210g/week) drinking. Cumulative alcohol burdens were evaluated in the following ways: (1) cumulative number of moderate to heavy drinking at each health examination (0 to 4 times); (2) drinking patterns in each cumulative alcohol burden (total 16 patterns). The incidence of total stroke, ischemic stroke (IS) or hemorrhagic stroke, was evaluated using Cox proportional-hazards models. Results: During a median follow-up of 5.6±1.2 years, 3093 (0.20%) subjects were diagnosed with stroke (1732 with ischemic and 1513 with hemorrhagic). Heavy drinkers were associated with an increased risk of total stroke compared to non-drinker (HR 1.256, 95% CI 1.112-1.419). The hazard ratio was proportional to the cumulative alcohol burdens (Fig. panel A). This positive linear relationship was mainly driven by hemorrhagic stroke rather than IS (Fig. panel B). While most drinking patterns were not associated with an increased risk of IS, alcohol burden 3 had a significant association with an increased risk of a hemorrhagic stroke (Fig. panel C). Conclusions: Moderate to heavy alcohol consumption has a cumulative association with a higher risk of stroke, especially for hemorrhagic stroke in young adults.