Cumulative Alcohol Consumption Burden and the Risk of Stroke in Young Adults: A Nationwide Population-Based Study.

s: Alcohol consumption is one of the important modifiable risk factors for stroke in young adults. The association between the cumulative burden of alcohol consumption and its impact on incident stroke in young adults is unknown. We aimed to investigate the association between cumulative alcohol burden and the risk for stroke among young adults.Using data from the Korean National Health Insurance Service database, subjects between 20 and 39 years of age, who underwent 4 consecutive annual health examinations between 2009 and 2012, were included. The cumulative alcohol burden score of moderate to heavy drinking was evaluated by assigning a score of 1 for alcohol consumption ≥105 g/week at the health examination each year and calculating the sum of 4 years (0 to 4). Main outcome was incident stroke and its subtypes, ischemic stroke and hemorrhagic stroke during the follow-up period.Of 1 536 668 subjects (mean age of 29.5 years, male of 71.5%, median follow-up of 6-year), 3 153 experienced an incident stroke (incidence rate, 0.37 per 1000 person-years). After multivariable adjustment, subjects with alcohol burden scores of 2, 3, and 4, who consumed more than 105 g/week of alcohol for 2, 3, and 4 years, demonstrated significantly higher risks for stroke (Hazard ratio [HR] 1.19, 95% Confidence interval [CI] 1.05-1.34 for 2; HR 1.22, 95% CI 1.09-1.38 for 3; HR 1.23, 95% CI 1.10-1.38 for 4) compared to those with a burden score of 0. This positive dose-response relationship was primarily driven by hemorrhagic rather than ischemic stroke. High alcohol burden scores (i.e., 2, 3, and 4) were significantly associated with higher risks for hemorrhagic stroke (HR 1.30, 95% CI 1.10-1.54 for 2; HR 1.42, 95% CI 1.21-1.67 for 3; HR 1.36, 95% CI 1.16-1.59 for 4) compared to a burden score of 0.Young adults who engaged in moderate to heavy drinking demonstrated a higher risk for incident stroke, especially hemorrhagic stroke. Reducing alcohol consumption should be emphasized in young adults with heavy drinking habits as part of any stroke prevention strategy.