Protect your brain by cutting down on alcohol consumption

By Gina Park, CNN

(CNN) — It’s second nature for some people to pour a glass of wine on a nice evening or to pop open a can of beer during a sports event — but when does drinking become too much?

Heavy alcohol use, which researchers defined as regular alcohol consumption of three or more drinks per day, is linked to more severe brain bleeds (or a bleeding stroke) and earlier long-term brain damage, according to a study published November 5, in the journal Neurology.

“A bleeding stroke, or intracerebral hemorrhage, is when a blood vessel in the brain ruptures, causing blood to leak out and damage the surrounding brain tissue. Bleeding strokes account for about (15% to 20%) of all strokes,” Dr. Mitchell Elkind, chief science officer of brain health and stroke at the American Heart Association, said in an email. He was not part of the study.

“The other kind of stroke, about 80%, is an ischemic stroke, in which a clot or blockage of the blood vessel occurs and there is a lack of blood flow to part of the brain, causing it to die from lack of oxygen and nutrients,” Elkind said. “Bleeding strokes are typically more dangerous and disabling.”

Some 17% of adults in the United States binge drink and 6% drink heavily, according to the US Centers for Disease Control and Prevention. In 2024, 29.7 million Americans ages 12 and older had alcohol use disorder, a pattern of excessive alcohol consumption that can cause impairment of physical or mental health.

“People who were drinking an average of three glasses of alcohol per day had their brain bleeds on an average of 11 years younger than compared to people who were drinking less glasses of alcohol,” said Dr. M. Edip Gurol, the study’s lead author.

Who is at risk of a bleeding stroke?

In the United States, 795,000 people experience a stroke each year, and 10% of those are bleeding strokes.

“Unfortunately, anyone — even children — can have a bleeding stroke. But the risks go up quickly with age, especially after age 55 or so,” said Elkind, professor emeritus of neurology and epidemiology at Columbia University. “The most important risk factor for brain hemorrhage overall is high blood pressure, or hypertension. Hypertension increases with age. Recently we have been seeing more strokes in younger people due to increasing obesity, diabetes, and hypertension in young adults.”

Nearly half of American adults, or 119.9 million people, have hypertension or high blood pressure.

Some symptoms of high blood pressure include headaches, shortness of breath and nosebleeds.

“Another important cause of strokes in younger people is the use of illicit substances: so not just alcohol, but use of cocaine, methamphetamine and other stimulants, heroin and other injected drugs, can lead to strokes and brain hemorrhages,” Elkind said. “Alcohol — and stimulants, in particular — can increase blood pressure, leading to higher risk of strokes of all types, including bleeding.”

Other than stroke, hypertension can also cause chronic kidney disease, heart disease and artery disease.

“For patients who had a brain bleed or patients who have MRI markers of higher than usual brain bleeding risk such as brain microbleeds, I recommend them to completely stop alcohol intake or use it very sparingly,” said Gurol, a vascular neurologist at Mass General Brigham, suggesting no more than up to six times per year and never exceeding more than a glass over 24 hours.

Decreasing your risk of a bleeding stroke

Elkind recommends getting your blood pressure under control to help prevent a stroke.

“Get it checked by a doctor or at a local pharmacy,” he said, “and if elevated, get it under control through lifestyle change and medication, if needed.”

An easy way to lower blood pressure is to do aerobic exercises, such as walking. Following good walking form by standing tall with your shoulders back and swinging your arms and practicing conscious or nasal breathing will help regulate your body.

Changes in your diet, such as reducing salt intake and following a Mediterranean diet, can also improve heart health and lower blood pressure.

The new study’s findings were based on data collected from 1,600 adults with a median age of 75 who were hospitalized for intracerebral hemorrhage. Participants were all admitted patients at Massachusetts General Hospital in Boston and were predominantly White.

Since data was collected retrospectively, it “could be biased by the occurrence of the hemorrhage itself: people or proxies may report higher levels of alcohol consumption after a life-changing event like a cerebral hemorrhage. This could lead to biased estimates of the effect,” Elkind said. “In a true prospectively designed study, the data about alcohol consumption would be collected before the hemorrhage had occurred.”

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