Alcohol has a direct effect on blood coagulation and fibrinolysis. We studied how alcohol is related to common bleeding events (e.g., nose bleeding), as well as life-threatening bleeding events (e.g., hemorrhagic stroke) that required hospital care in the general population. We used data from The Copenhagen City Heart Study, 1991 to 1994 and 2001 to 2003. Baseline information on alcohol consumption and potential confounders was obtained by questionnaires, and participants were followed for incident bleeding events with nationwide registers until 2013.

Among the 10,259 included participants, we observed 366 nose or other respiratory organ bleeding events, 149 hemorrhagic stroke events, 470 gastrointestinal bleeding events, 266 unspecified bleeding events, and 1088 any-bleeding events (composite endpoint) during follow-up. Compared to drinkers of 1–6 drinks per week, those drinking ≥35 drinks per week had a higher risk of hemorrhagic stroke [hazard ratio, 2.27 (1.14–4.55)] and non-variceal gastrointestinal bleeding [hazard ratio 2.04 (1.37–3.05)], whereas non-drinkers and drinkers of 7–13, 14–20, 21–27, and 28–34 drinks per week had not. Alcohol consumption was not associated with risk of nose or other respiratory organ bleeding or unspecified bleeding. For non-drinkers and drinkers of 7–13, 14–20, 21–27, 28–34, and 35 or more drinks per week, hazard ratios for the composite endpoint of any bleeding were 1.17 (95% CI: 0.99–1.37), 0.97 (95% CI: 0.81–1.15), 1.00 (95% CI: 0.80–1.26), 0.93 (95% CI: 0.69–1.25), 1.39 (95% CI: 1.00–1.94), and 1.83 (95% CI: 1.39–2.41) compared to drinkers of 1–6 drinks per week.

In conclusion, drinking 35 or more drinks per week may be associated with a higher risk of hemorrhagic stroke and non-variceal gastrointestinal bleeding in the general population.

酒精对血液凝固和纤维蛋白溶解有直接影响。我们研究了酒精与普通人群中需要住院治疗的常见出血事件（例如鼻出血）以及危及生命的出血事件（例如出血性中风）之间的关系。我们使用了来自哥本哈根城市心脏研究（1991 年至 1994 年和 2001 年至 2003 年）的数据。通过问卷获得有关饮酒和潜在混杂因素的基线信息，并在 2013 年之前通过全国登记跟踪参与者的出血事件。

在纳入的 10,259 名参与者中，我们在随访期间观察到 366 次鼻子或其他呼吸器官出血事件、149 次出血性卒中事件、470 次胃肠道出血事件、266 次未指定出血事件和 1088 次任何出血事件（复合终点）。与每周饮酒 1-6 杯的人相比，每周饮酒 35 杯以上的人患出血性中风 [危险比，2.27 (1.14-4.55)] 和非静脉曲张性胃肠道出血 [危险比 2.04 (1.37-3.05) 的风险更高)]，而每周饮酒 7-13、14-20、21-27 和 28-34 次的非饮酒者和饮酒者则没有。饮酒与鼻子或其他呼吸器官出血或不明出血的风险无关。对于每周 7–13、14–20、21–27、28–34 和 35 或更多酒的非饮酒者和饮酒者，

总之，在一般人群中，每周饮酒 35 次或更多可能与出血性中风和非静脉曲张性胃肠道出血的风险增加有关。