Trying to prevent a stroke is difficult when dangers are present in daily life. For instance, the integration of a substance like caffeine in society is prominent, whether it is a part of the regular work routine or part of social gatherings. Despite its regular uses, caffeine is known as a substance that stimulates the central nervous system [1]. Similarly, we have normalized alcohol as an acceptable substance to use. The integration of alcohol consumption ranges from consuming alcohol at social events to being used as a coping mechanism for a long week at work. Alcohol is a substance that alters the central nervous system as well. Unlike caffeine, alcohol is a depressant for the central nervous system [2]. Alcohol influences most organs, and therefore it is important to understand how it can increase your risk of having a stroke [2]. Healthcare professionals advise us to limit alcohol consumption when we want to curb cardiovascular disease risk. Alcoholic beverages have high levels of sodium, sugars, and saturated fat. Excessive consumption of sodium, sugars and saturated fat can lead to numerous health issues [5]. The risk for cardiovascular disease can vary depending on different factors such as sex, intake amount, frequency, drinking patterns, and the type of alcoholic drink [3]. 

There are different patterns of drinking and/or alcohol consumption. There’s low-risk, moderate, binge, and heavy consumption [3]. Centers for Disease Control and Prevention (CDC) state that for males, drinking moderately consists of drinking two drinks or less in a day whereas for women it is one drink or less [2]. Binge drinking is about five or more drinks in a single instance for males and four or more for women [2]. A heavy pattern of alcohol consumption generally equates to fifteen drinks or more per week for males and eight or more per week for females. Low-risk drinking means consuming alcohol at levels that are thought to be relatively safe, although consuming alcohol itself is not free of risk. 

Drinking limits are different for males and females because each sex absorbs alcohol differently [3]. Females have a slower metabolism and take longer to remove alcohol from their system, leading them to become more susceptible to certain forms of heart disease [3]. When both sexes consume the same amount of alcohol, females are more sensitive to the negative consequences [3]. However, in one study, researchers found that consuming alcohol moderately reduces risk of hypertension in females but increases this same risk in men [8]. Additionally, consuming alcohol moderately is associated with an increased risk of atrial fibrillation in males, but the same connection is not observed in females [3]. However, consuming alcohol moderately does cause an increased risk of death for females [3]. All the differences we have mentioned so far are related to biological differences and lifestyle habits. For instance, in social settings females may consume less alcohol than males which can help explain why females might have varied alcohol sensitivities [3]. 

Some scientists define moderate intake when an individual consumes alcohol fairly consistently and low intake when a person drinks occasionally with some days without consumption [3]. Many people do not have a consistent pattern of consumption [3]. However, consuming alcohol at low or moderate levels in combination with periods of heavy and/or binge drinking are not healthy behaviours [3]. When it comes to cardiovascular disease, low to moderate intake is better than abusive drinking [3]. When drinking patterns are heavy and/or on the binge level, the prevalence of arterial stiffness and stroke increases in comparison to moderate drinking patterns [3]. Stiff arteries can result in increased blood pressure or hypertension, which further increases the risk for cardiovascular disease [6][7]. Those who practice heavy/binge drinking in early adulthood are more likely to stop after 35 years of age [3]. However, individuals who drank heavily from an early age have an increased risk for cardiovascular disease in comparison to those who participate in moderate drinking over their lifetime [3]. Drinking heavily and irregularly relates to an increase in risk for cardiovascular disease because persistent drinking behaviours can increase blood pressure, arrhythmias, and cholesterol levels [3]. 

Ethnic minorities disproportionately suffer from alcohol-related problems [9]. This is due to numerous factors, ranging from poverty to chronic stresses [9]. Moreover, frequent drinking during or after the young adulthood stage can cause troubles with alcohol in middle adulthood [9]. Even after accounting for ethnic differences, the detrimental effects of consuming alcohol in a heavy manner affect individuals across the globe [3]. White and Hispanic populations have reduced risk of all causes of death when compared to Black, Indian, and Chinese populations that are disproportionately affected by certain diseases [3]. Similar disparities exist when it comes to the risk of cardiovascular disease, where the use of alcohol seems to be protective for White individuals but not Black individuals regardless of consumption level [3]. Comparing Asian to non-Asian groups, Asian populations seem to have a higher risk of hypertension and stroke even with the same alcohol consumption levels [3]. Overall, both genetic variation and culture practices contribute to diverse patterns of drinking and lifestyles [3]. The protective mechanisms with low and/or moderate alcohol consumption varies significantly across ethnic populations [3].

The type of drink influences risk as well. Risk for a heart attack is highest for those who consume beer and liquor, followed by white wine and lowest for red wine [3]. These alcoholic drinks are a result of fermentation, with approximately 14% alcohol content in red wine, 11% in white wine, and 5% in beer [3]. Liquor products have approximately 35% alcohol [3]. All these drinks have different chemical makeups which lead to varying impacts on health, however, liquors seem to be the most harmful [3]. For females, drinking wine at low to moderate levels has a reduced risk of stroke compared to individuals who consume beer in the low to moderate range [3]. It is unknown and hard to see whether the risk for major adverse cardiovascular events is lower because most people who drink do not consume one type [3]. 

Although there can be protective effects of consuming alcohol in a specific manner, it is best for those who currently drink to keep consumption in the low to moderate range and for those who do not drink, it is not beneficial to start drinking to improve health [3]. Generally, Canada’s food guide emphasizes making water the drink of choice [5]. For those of legal age who choose to consume alcohol, Canada provides guidelines for low-risk alcohol drinking [4]. Recommendations for alcohol consumption differ throughout the world. If information relating to recommended alcohol consumption limits is unavailable, CDC offers them as well. However, be sure to talk to your health care provider about what the best and safest option is for you.  

Author: Manasee Vyas

References

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[2] Centers for Disease Control and Prevention. (2021, February 16). Alcohol Questions and Answers. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/alcohol/faqs.htm

[3] Chiva-Blanch, G., & Badimon, L. (2019). Benefits and Risks of Moderate Alcohol Consumption on Cardiovascular Disease: Current Findings and Controversies. Nutrients, 12(1), 108. https://doi.org/10.3390/nu12010108

[4] Canadian Centre on Substance Use and Addiction (2018). Canada’s low-risk alcohol drinking guidelines [Brochure]. https://www.ccsa.ca/sites/default/files/2020-07/2012-Canada-Low-Risk-Alcohol-Drinking-Guidelines-Brochure-en_0.pdf

[5] Health Canada. (2021, January 26). Make water your drink of choice. Canada Food Guide. https://food-guide.canada.ca/en/healthy-eating-recommendations/make-water-your-drink-of-choice/

[6] Shirwany, N. A., & Zou, M. H. (2010). Arterial stiffness: a brief review. Acta Pharmacologica Sinica, 31(10), 1267–1276. https://doi.org/10.1038/aps.2010.123

[7] Whelton, P. K. (2019). Evolution of Blood Pressure Clinical Practice Guidelines: A Personal Perspective. Canadian Journal of Cardiology, 35(5), 570–581. https://doi.org/10.1016/j.cjca.2019.02.019

[8] Tolstrup, J., Jensen, M. K., Anne, T., Overvad, K., Mukamal, K. J., & Grønbæk, M. (2006). Prospective study of alcohol drinking patterns and coronary heart disease in women and men. BMJ, 332(7552), 1244. https://doi.org/10.1136/bmj.38831.503113.7c

[9] Mulia, N., Karriker-Jaffe, K. J., Witbrodt, J., Bond, J., Williams, E., & Zemore, S. E. (2016). Racial/Ethnic Differences in 30-year Trajectories of Heavy Drinking in a Nationally Representative U.S. Sample. Drug and Alcohol Dependence, 170, 133–141. https://doi.org/10.1016/j.drugalcdep.2016.10.031