Can alcohol be beneficial?

Alcohol may be beneficial, but only if drunk in small to moderate amounts. At higher levels, it can harm your health. Drinking regular, small amounts of all types of alcohol may reduce your risk of heart disease. It is generally thought that a unit or two, some days of the week, probably protects adults of all ages against heart disease.

Research shows that small amounts of alcohol may help to thin the blood and reduce the risk of clots forming in blood vessels. It may also affect the way that cholesterol is carried in the bloodstream, reducing the risk of fatty deposits building up in blood vessel walls. This can reduce the risk of ischaemic strokes, where clots or fatty build-up cause a blockage in a blood vessel. 

Although drinking small amounts of alcohol a day has been found to offer some protection against heart attack and stroke, there are still more effective ways to protect your health. These include eating a healthy diet, staying active, getting enough sleep, and having regular health checks as recommended by your doctor.

Staying in Control When Drinking

If you drink, it is vital to work out how many units you are having so that you can keep within sensible limits. For a couple of weeks, at the end of each day, make a note of what you drank and count up the units.You could also keep track using a computer or a smart phone app. If you would like help, you could also speak to your GP or practice nurse, or contact some of the organizations listed at the end of this fact sheet.

• 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 (such as the ‘quick drink’ after work). 
• Tell your family and friends you’re cutting down – they may be more supportive than you’d expect.
• Don’t drink on an empty stomach. Have a good meal before you go out, or limit your drinking to mealtimes only. Drinking with food slows the rate of absorption of the alcohol into your bloodstream, and should help you to get a better night’s sleep.
• Top up the water before the wine glasses.  
• If you’re out drinking in a group, avoid buying rounds, as this can encourage you to drink more alcohol more quickly. Go to a place that serves food, as eating will slow down the effects of alcohol. 
• Experiment with flavours – use slices of fruit to add extra zing or try non-alcoholic versions of your usual drinks. There are plenty of fruit drinks and alcohol-free wines and beers on the market.
• Suggest an alcohol-free outing with your friends instead of meeting for a drink – there are plenty of alternatives, from visiting a place of interest to going to the cinema, and they will not necessarily cost any more than going to the pub.
• If you’re drinking at home, try not to pour larger drinks than you would get if you were drinking in a pub or restaurant.  
• Serve spritzers and other mixed drinks at home that can be made in lower alcohol versions, like cocktails or fruit punch.
• Keep a range of non-alcoholic drinks that you like at home, or try making smoothies and non-alcoholic cocktails.
• Have regular alcohol-free days to avoid becoming dependent on drink.  
• If you need to relax, try some less harmful ways to manage your stress like soaking in a warm bath or shower, having a massage or talking to a trusted friend.
• Depression is often associated with alcohol use, and should improve as you start to drink less. Depression is also common after a stroke.

Can I drink alcohol after a stroke?

The effects of alcohol may put you at further risk after a stroke, and you will need to review your drinking and consider cutting down, especially if you were a heavy drinker beforehand. There are a number of factors you need to consider – talk to your GP for more advice:

• Following a stroke you may be more vulnerable to alcohol and its negative effects such as sleep disturbance, poor balance and impaired speech. Alcohol may worsen mood swings and depression, which are common after a stroke. It may affect your memory and thinking, making you forgetful and less able to make sound judgements.
• If you are out after dark, you should remember that alcohol can reduce night vision by 25 per cent and slow down reaction times by 10-30 per cent.  
• Alcohol acts on the kidneys, creating excessive amounts of urine, which may make you dehydrated. 
• If you are less active than before your stroke, you will need to reduce your calorie intake (especially these ‘empty’ calories) to avoid becoming overweight. If you are less active and not absorbing calcium properly, your bones may become weakened.
• Drinking alcohol may be harmful when taking medicines that are sometimes needed after a stroke. Ask your GP or pharmacist about whether you may drink at all and if so, what the sensible limits are for you. You may be advised to stop drinking for the first month or two after starting a new medicine so that your body can get used to its effects.
• If you do drink you should ask at your anticoagulant clinic about your alcohol intake and how much you can safely drink on a regular basis.

Drinking alcohol after a stroke due to bleeding in the brain (a haemorrhagic stroke) could put you at particular risk. You will need to avoid alcohol for at least the first three weeks, and be advised by your doctor after that.

How does drinking alcohol increase the risk of stroke?

How does drinking alcohol increase the risk of stroke? - Alcohol contributes to diseases that affect the circulation of the blood, such as high blood pressure and diabetes, and these in turn raise our risk of stroke. Excessive drinking (where the recommended limits are regularly exceeded) and ‘binge’ drinking, can both raise blood pressure, which is the main risk factor for stroke. 

High blood pressure develops when the pressure of the blood passing through the blood vessels is consistently high – above 140/90 mmHg. Ideally, blood pressure should be no higher than 120/80 mmHg. Type 2 diabetes can be triggered by heavy drinking as a result of changes in how the body responds to insulin. Heavy drinking also causes pancreatitis (inflammation of the pancreas) which can reduce insulin production, and one in three people with this condition will develop diabetes. (For further information please see our factsheet F15, Diabetes and stroke. Drinking alcohol in excess can also trigger atrial fibrillation, a type of irregular heartbeat which also raises the risk of stroke. (For further information please see our factsheet F26, Atrial fibrillation and stroke). 

Even in moderate amounts, alcohol may lead to a rise in the blood level of a substance called homocysteine. This can increase the risk of your blood clotting and is also linked to atherosclerosis (hardening and furring of the internal walls of the arteries). This can result in a blockage forming, which could lead to a stroke.

Stroke Home Treatment

After a stroke, home treatment will be an important part of your rehabilitation. You may need to use assistive devices to help you:

• Walk. Canes and walkers can be used to help prevent falls. 

• Get dressed. Devices called reachers can help you put on socks or stockings if you have weakness in one arm or hand. 

• Eat. Large-handled silverware can be easier to grab and use if you have a weak hand. If you have trouble swallowing, you may need to change your diet or your doctor may provide you with a feeding tube to use at home.

Tips for dealing with the effects of a stroke :

• Managing eating problems.

• Managing vision problems.

• Managing getting dressed.

• Managing bowel and bladder problems.

Tips for a successful recovery

• Participate in a stroke rehabilitation program as soon as possible.

• Recognize and deal with depression.

• Be as involved as possible in your care.

Although stroke rehab is increasingly successful at prolonging life, a stroke can be a disabling or fatal condition.People who have had a stroke may consider discussing health care and other legal issues that may arise near the end of life.Many people find it helpful and comforting to state their health care choices in writing with a living will or other advance directive while they are still able to make and communicate these decisions.