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Alcohol and Stroke Risk — SCE Neurology MCQ

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EasyCerebrovascular DiseaseAlcohol and Stroke RiskSCE Neurology

A 65-year-old man with a completed ischaemic stroke is being discharged. He was a moderate drinker (20 units/week). His neurologist discusses alcohol and stroke risk. What is the evidence-based advice?

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Correct answer: E — There is a J-shaped relationship — light-moderate alcohol consumption may be associated with lower ischaemic stroke risk, but heavy consumption significantly increases both ischaemic and haemorrhagic stroke risk; current UK guidance recommends no more than 14 units/week

The relationship between alcohol and stroke risk follows a J-shaped curve for ischaemic stroke (light-moderate consumption may have a modest protective effect via HDL elevation and reduced platelet aggregation) but a linear relationship for haemorrhagic stroke (any alcohol increases risk). Heavy drinking (>14 units/week for men and women) significantly increases both types. UK CMO guidelines recommend ≤14 units/week spread over 3+ days. After stroke, reducing alcohol consumption is part of secondary prevention. A: Alcohol significantly affects stroke risk. C: Complete avoidance is not mandated at moderate levels. D: Heavy drinking increases risk. E: All alcohol types contribute.

Reference: RCP Stroke Guidelines; UK CMO Alcohol Guidelines (2016)