Alcohol and stroke

Alcohol is part of life for many people. Many of us enjoy a drink as part of a social occasion or a meal, and alcohol is often used as part of celebrations.  

But alcohol can increase your risk of stroke, even if you don’t drink very large amounts. And if you’ve had a stroke, alcohol could increase your risk of another stroke. 

Guidelines on safe levels of drinking

The UK government guidelines advise that to keep your risk low, you are safest not to regularly drink more than 14 units per week. 

If you do drink as much as 14 units per week, it is best to spread this evenly across the week. This limit is the same for men and women. See below for more information about units, and tips on drinking safely. 

How alcohol can increase your risk of stroke

Regularly drinking more than the safe level of alcohol can increase your risk of  a stroke, because it contributes to medical conditions that are risk factors for stroke.

  1. High blood pressure is the most important risk factor for stroke, contributing to over 50% of all strokes in the UK. Drinking too much alcohol raises your blood pressure.
     
  2. Diabetes almost doubles your risk of stroke. Drinking more than the safe limit raise your risk of getting type 2 diabetes.
     
  3. Being overweight increases your risk of having a stroke. Alcoholic drinks tend to be very high in calories, so regularly drinking lots of alcohol can make it more difficult to maintain a healthy weight.
     
  4. Drinking large amounts of alcohol can trigger atrial fibrillation, a type of irregular heartbeat linked to an increased risk of stroke.
     
  5. Liver damage due to too much alcohol can stop the liver from making substances that help your blood to clot. This can increase your risk of a stroke caused by bleeding in your brain. 

Can I drink alcohol after a stroke?

If you have had a stroke or transient ischaemic attack (TIA or mini-stroke), it’s a good idea to get some individual advice about alcohol. It’s likely that you can drink, but it may be more important to stick within the guidelines for safe levels of drinking.

Reduce your risk of another stroke

Discuss your levels of drinking with your stroke nurse or GP. If they feel that alcohol could raise your risk of another stroke or TIA, they can give you advice and help you find support to cut down.

Medication

Drinking more than the safe limit, or binge drinking, while blood-thinning medication can raise your risk of bleeding. Check with your pharmacist whether you can drink alcohol while taking any medication.

Nimodipine is often given after a type of stroke due to bleeding on the brain (a subarachnoid haemorrhage). Drinking alcohol while taking Nimodipine can lead to headaches and dizziness.

Alcohol and wellbeing after a stroke

If you’ve had a stroke, you may be more vulnerable to the negative effects that alcohol can have. If you’re sleeping badly, have poor balance or speech problems, alcohol could make these worse.

Alcohol can also worsen mood swings and depression, which are common after stroke. It can also affect your memory and thinking.

Alcohol makes you dehydrated, and this can make headaches worse. 

Do I need to cut down?

It’s not always easy to know if you are drinking over the safe level of alcohol. Your usual drinks may contain more units than you realised. Or you might have a few drinks after work every day, adding up to more than you think.

First you need to work out how many units you’re drinking. You can find out by keeping a drinks diary. For a couple of weeks, at the end of each day, make a note of what you drank and count up the units. If you find that you are regularly drinking more than the recommended limit, some of the following tips may help you cut down. Ask your GP for advice, and look for organisations, websites and phone apps that can help you do this. 

Problem drinking

If you feel that you may be drinking too much or you can’t control your drinking, it’s especially important to talk about it. Help is available through your GP, and there are local alcohol support groups in many areas. If you want to talk to someone about your drinking, contact the free national alcohol helpline Drinkline 0300 123 1110. There is more information about support at nhs.uk/alcohol

Tips for cutting down

First of all you need to work out how many units you’re drinking. You can find out by keeping a ‘drinks diary’.

For a couple of weeks, at the end of each day, make a note of what you drank and count up the units. There are lots of websites and phone apps that can help you do this. NHS Choices has a range of tools and trackers that can help you.

If you find that you are regularly drinking more than the recommended amount, you need to start cutting down. Speak to your GP or practice nurse for help and support.

When it comes to single drinking occasions, you can keep the short-term health risks at a low level by sticking to a few simple rules:

  • Set yourself a daily alcohol limit and stick to it. Work out when you do most of your drinking and see if there are obvious times when you can cut back.
  • Ask for support. Tell your family and friends that you’re cutting down – they can help you reach your goals.
  • Don’t drink on an empty stomach. Eating something slows down the rate that alcohol is absorbed into your bloodstream.
  • Have regular alcohol-free days to avoid becoming dependent on alcohol. Alternate each alcoholic drink with a glass of water or a soft drink. This can help you cut down on the amount of alcohol you’re drinking, and avoid becoming dehydrated.
  • Avoid buying rounds if you’re in a group, as this can encourage everyone in the group to drink more.
  • Try alternatives to alcohol, and experiment with flavours. Try using slices of fruit to add extra zing or try non-alcoholic versions of your usual drinks. Look for fruit drinks and alcohol-free wines and beers.
  • Go for smaller sizes such as a bottle of beer instead of a pint, or a small glass of wine instead of a large. And when you drink at home, try to pour smaller drinks than you would get in a pub or restaurant.
  • Keep a range of non-alcoholic drinks that you like at home, or try making smoothies or non-alcoholic cocktails. Or you could serve drinks that are lower in alcohol, like spritzers, cocktails or fruit punches.
  • Low mood or depression is common after a stroke, and is often a reason why people drink. If you’re feeling low or depressed, then talk to someone about it. Your doctor will be able to tell you about help and support that is available.
  • Many people like to drink because it helps them relax. So try to find other things that will help you do this such as exercising, relaxation sessions or complementary therapies. 

Quick guide to alcohol units

What does 14 units look like?

One unit is 10ml of pure alcohol. Because alcoholic drinks come in different strengths and sizes, it’s not as simple as one drink, one unit.

The weekly safe limit of 14 units is equivalent to:

  • Six pints of average strength beer.
  • Six 175ml glasses of average strength wine.

To find out how many units are in each drink you have, visit the Drinkaware online unit tracker

How many alcohol units do you consume?

Watch this video from Drinkaware to find out more about units of alcohol.

Find out more

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