Drinking moderate amounts of alcohol is linked to reduced risk of heart failure
Evidence already
exists for the beneficial effects of drinking moderate amounts of alcohol on
the risk of developing a number of heart conditions; however, the role it plays
in the risk of developing heart failure has been under-researched with
conflicting results.
Now, a large study
of nearly 15,000 men and women, published online January 20, 2015 in the European
Heart Journal, shows that drinking up to seven drinks a week in early to
middle age is associated with a 20% lower risk of men developing heart failure
in the future when compared to people who did not drink at all, and a more
modest 16% reduced risk for women.
Heart failure is a
condition in which the heart can no longer pump blood around the body as well
as it used to. The most common reason is that the heart muscle has been
damaged, for instance by a heart attack. High blood pressure, heart muscle
disease (cardiomyopathy), heart valve problems, an irregular heart beat
(arrhythmia), viral infections, drinking excessive amounts of alcohol, consuming
recreational drugs and the side-effects of radiotherapy treatment for cancer
can all contribute to heart failure developing. Heart failure is a major public
health problem with over 23 million people living with it worldwide.
Dr Scott Solomon,
Professor of Medicine at Harvard Medical School and Senior Physician at Brigham
and Women's Hospital, Boston, USA, Dr Alexandra Gonçalves, a research fellow at
Brigham and Women's Hospital, and colleagues analysed data from 14,629 people
aged between 45-64 years who had been recruited to the Atherosclerosis Risk in
Communities Study between 1987 and 1989 in four communities in the USA. They
followed the participants for 24-25 years to the end of 2011, and they
questioned them about their alcohol consumption at the start and at each of the
three subsequent visits made at three-yearly intervals.
They defined a drink
as one that contains 14g of alcohol, equivalent to approximately one small
(125ml) glass of wine, just over half a pint or a third of a litre of beer, and
less than one shot of liquor such as whisky or vodka. The study participants
were divided into six categories: abstainers (people who recorded having drunk
no alcohol at every visit by the researchers), former drinkers, people who
drank up to seven drinks a week, or between 7-14 drinks, 14-21 drinks, or 21 or
more drinks a week.
During the follow-up
period 1271 men and 1237 women developed heart failure. The lowest rate of
heart failures occurred in those drinking up to 7 drinks per week and the
highest rate was seen among former drinkers.
After taking account
of various factors that could affect the results such as age, diabetes, high
blood pressure, heart disease or heart attacks, body mass index, cholesterol
levels, physical activity, education and smoking, men who consumed up to seven
drinks a week had a 20% reduced risk of developing heart failure compared to
abstainers, while the risk was reduced by 16% in women consuming the same
amount. Former drinkers had the highest risk of developing heart failure -- a
19% and 17% increased risk among men and women respectively compared to
abstainers. Interestingly, among both men and women consuming the most amount
of alcohol (14 or more drinks a week), the risk of heart failure was not
significantly different compared to the risk for abstainers. Drinking excessive
amounts of alcohol over a long period of time is known to increase the risk of
cardiomyopathy. However, the number of very heavy drinkers in the study was
small, which could have limited its power to detect such an association.
However, when the
researchers looked at death from any cause, there was an increased risk of
death of 47% for men and 89% of women who reported consuming 21 or more drinks
a week at the start of the study.
Professor Solomon
said: "These findings suggest that drinking alcohol in moderation does not
contribute to an increased risk of heart failure and may even be protective. No
level of alcohol intake was associated with a higher risk of heart failure.
However, heavy alcohol use is certainly a risk factor for deaths from any
cause.
"The people who
were classified as former drinkers at the start of the study had a higher risk
of developing heart failure and of death from any cause when compared with
abstainers. This could be related to the reasons why they had stopped drinking
in the first place, for instance because they had already developed health
problems that might have made them more likely to go on to develop heart
failure."
The protective
effect of moderate drinking were more marginal in women than in men and the
authors think this may be due to the fact that women metabolise alcohol in a
different way to men and it can affect them differently.
Overall, most
participants were abstainers (42%) or former drinkers (19%), with 25% reporting
up to seven drinks a week, eight percent reporting seven to 14 drinks a week,
and three percent reporting drinking 14-21 and 21 or more drinks a week
respectively. Most drinkers also drank more than one type of drink. This meant
that the researchers were unable to assess the role of binge drinking or any
differences between types of drink.
"It is
important to bear in mind that our study shows there is an association between
drinking moderate amounts of alcohol and a lower risk of heart failure but this
does not necessarily mean that moderate alcohol consumption causes the lowered
risk, although we did adjust our results to take account, as far as possible,
for a variety of other lifestyle factors that could affect a person's
risk," concluded Professor Solomon.
Wine
only protects against cardiovascular disease (CVD) in people who exercise,
according to results from the In Vino Veritas (IVV) study presented at ESC
Congress September 2, 2014 by Professor
Milos Taborsky from the Czech Republic.
Professor
Taborsky said: "This is the first randomised trial comparing the effects
of red and white wine on markers of atherosclerosis (1) in people at mild to
moderate risk of CVD. We found that moderate wine drinking was only protective
in people who exercised. Red and white wine produced the same results."
Evidence
suggesting that mild to moderate consumption of wine protects against
cardiovascular disease has been accumulating since the early 1990s. In
particular, retrospective studies have found that wine increases levels of HDL,
the "good" cholesterol. But until now there has been no long-term,
prospective, randomised study comparing the effects of red and white wine on
HDL cholesterol and other markers of atherosclerosis.
The
IVV study (2) is the first long-term, prospective randomised trial comparing
the effect of red and white wine on markers of atherosclerosis. The study
included 146 people with mild to moderate risk of cardiovascular disease
according to the HeartScore (3). Participants were randomised to one year of moderate
consumption of red wine (Pinot Noir) or white wine (Chardonnay-Pinot) from the
same year and wine region of the Czech Republic.
Moderate
consumption was the World Health Organization definition of 0.2 L for women and
0.3 L for men, a maximum of five times a week. The primary endpoint was the
level of HDL cholesterol at one year. Secondary endpoints were levels of other
markers of atherosclerosis including LDL cholesterol. Participants consumed
their usual diet.
Participants
kept a logbook on their consumption of wine and other alcoholic beverages,
medication use, and amount and type of exercise. They were required to return
the corks from the wine bottles to confirm that they had drank the wine rather
than sold it.
The
researchers found that there was no difference between HDL cholesterol levels
at the beginning of the study compared to one year in either the red or white
wine groups. LDL cholesterol was lower in both groups at one year while total
cholesterol was lower only in the red wine group.
Professor
Taborsky said: "A rise in HDL cholesterol is the main indication of a
protective effect against CVD, therefore we can conclude that neither red or
white wine had any impact on study participants as a whole."
He
added: "The only positive and continuous result was in the subgroup of
patients who took more exercise, which means regular exercise at least twice a
week, plus the wine consumption. In this group HDL cholesterol increased and
LDL and total cholesterol decreased in the red and white wine groups. There may
be some synergy between the low dose of ethyl alcohol in wine and exercise
which is protective against CVD."
He
continued: "In a future study we will compare the effects of red and white
wine on markers of atherosclerosis in patients at high risk for CVD who take
statins and do regular exercise. We hope to find that moderate wine consumption
is safe in these patients."
Professor
Taborsky concluded: "Our current study shows that the combination of
moderate wine drinking plus regular exercise improves markers of
atherosclerosis, suggesting that this combination is protective against
cardiovascular disease."
Wine and heart health
The National Institute of Health:
Studies
have shown that adults who drink light to moderate amounts of alcohol may be
less likely to develop heart disease than those who do not drink at all or are
heavy drinkers. Persons who do not drink alcohol should not start just because
they want to avoid developing heart disease.
There
is a fine line between healthy drinking and risky drinking. It is not
recommended that you begin drinking or drink more often just to lower your risk
of heart disease.
Health
care providers recommend that if you drink alcohol, drink only light to
moderate amounts:
·
For men, limit alcohol to 1 to 2
drinks a day.
·
For women, limit alcohol to 1 drink
a day.
One drink is
defined as:
·
4 ounces of wine
·
12 ounces of beer
·
1½ ounces of 80-proof spirits
·
1 ounce of 100-proof spirits
Heavier drinking can harm the heart and liver. Heart disease
is the leading cause of death in people who abuse alcohol.
Alcohol may help the heart when used in light to moderate
amounts:
·
Increases the amount of HDL
("good") cholesterol
·
Decreases the chance of forming
clots in blood vessels
·
Decreases inflammation
- Increases antioxidant activity (red wine contains antioxidants called flavonoids)
Alcohol In Moderation Lowers Risk Of Second Heart Attack
The online issue
of the European Heart Journal reports
that a study of almost 2,000 American men has demonstrated that men who
survived a first heart attack and who consume alcohol in moderation have a
lower risk of dying from heart disease or any other cause than non-drinkers.
The latest
results from the US Health Professionals Follow-up Study, a prospective study
of 51,529 US male health professionals, demonstrates that the any-cause
mortality risk for men who survived a first heart attack and who consumed about
two alcoholic drinks daily over an extended period of time was 14% lower, and
the risk of dying from cardiovascular disease was 42% lower than in men who did
not consume alcohol.
First author,
Dr. Jennifer Pai, assistant professor of medicine at Channing Laboratory,
Department of Medicine, Brigham and Women's Hospital and Harvard Medical
School, and a research associate at Harvard School of Public Health, declared:
"Our
findings clearly demonstrate that long-term moderate alcohol consumption among
men who survived a heart attack was associated with a reduced risk of total and
cardiovascular mortality. We also found that among men who consumed moderate
amounts of alcohol prior to a heart attack, those who continued to consume
alcohol 'in moderation' afterwards also had better long term prognosis."
Scientists know
that amongst the healthy population, moderate alcohol consumption is linked to
a lower risk of heart disease and death; however, whether the same applies to
people with established heart disease is not known. There have been no
prospective studies until now that measured alcohol consumption both before and
after a heart attack, with long-term follow-up.
Dr. Pai and her
team assessed a subset of 1,818 men in the Health Professionals Follow-up Study
who survived a first heart attack between 1986 and 2006 and followed up 20
years from the time of their heart attack. 468 men died during the study
period.
Every two years,
the participants completed a survey regarding their lifestyle and medical
factors, including their body mass index, their smoking habits, etc. and every
four years they were surveyed regarding their alcohol consumption of beer, red
wine and spirits and their diet.
A standard
portion was defined as a 4oz or 125 ml of wine, which contains 11g of ethanol,
i.e. the alcohol in the drink, a bottle or can of beer that contains 12.8g of
ethanol, or a shot of spirits, which contains 14g of ethanol.
The men were
categorized into four groups based on their daily alcohol intake, for instance
0g, 0.1-9.9g, 10-29.9g, and 30g or more. Between 10 to 29.9g of alcohol per
day, i.e. the equivalent of about two drinks was classed as
"moderate" drinking.
After adjusting
for various variables, including smoking, body mass index, age and medical
history, the researchers discovered that men who consumed about two alcoholic
drinks per day following their first heart attack had a lower any-cause
mortality risk as compared with non-drinkers, regardless of the type of drink
they consumed.
The researchers
examined the participants' alcohol consumption before and after the heart
attack and discovered that the majority of men had not changed their drinking
habits, and those who drank alcohol before and after their heart attack were
more likely to have a lower risk of death compared with those who drank no
alcohol. The researchers note, however, that the results were statistically not
important because of the smaller numbers in their analysis.
They also
observed a "U" shape in the results that demonstrated that
participants' who drank 30g or more alcohol daily had a similar any-cause
mortality risk to that of non-drinkers.
Dr. Pai
explains:
"The
adverse health effects of heavy drinking are well known, and include high blood
pressure, reduced heart function and reduced ability to break down blood clots.
In addition, other studies have shown that any benefits from light drinking are
entirely eliminated after episodes of binge drinking.
Our results,
showing the greatest benefit among moderate drinkers and a suggestion of excess
mortality among men who consumed more than two drinks a day after a heart
attack, emphasize the importance of alcohol in moderation."
She continued,
saying:
"The
findings of our study support the European Society of Cardiology recommended
guidelines for long-term management of acute coronary syndromes that moderate
alcohol consumption of 10-30 grams per day in men should not be discouraged and
may be beneficial for long-term prognosis after a heart attack.
If the men were
already consuming moderate amounts, then it may be beneficial to continue
consuming moderate amounts of alcohol after a myocardial infarction. However,
because excessive alcohol intake is harmful, we recommend that patients discuss
drinking alcohol in moderation with their physicians to individually assess
their risks and potential benefits."
The researchers
are aware of the study's limitations, for instance, the fact that surveys
reporting alcohol intake may include measurement errors, as well as treatments
of heart attacks having changed in the last two decades, and that the findings
only relate to drinking in men, although they do not believe that these factors
affect the result's validity.
Dr. Pai
concluded:
"Our study
was only among men, so we cannot extrapolate to women. However, in all other
cases of alcohol and chronic disease, associations are similar except at lower
quantities for women. Thus, an association is likely to be observed at 5-14.9g
per day, or up to a drink a day for women."
Light-to-moderate alcohol consumption=lower
stroke risk in women
According to new
research from Brigham and Women's Hospital (BWH), light-to-moderate alcohol
consumption was associated with a lower risk of stroke in women.
The study was
published on March 8, 2012 in Stroke,
a journal of the American Heart Association (AHA).
Monik Jimenez
ScD, BWH Department of Medicine, examined data from 83,578 female participants
in the Nurses' Health Study. They looked at data of women who had no evidence
of cardiovascular disease or cancer at baseline and followed them for up to 26
years. Participants provided information on diet, including self-reported alcohol
consumption, lifestyle factors and stroke events.
There were 2,171
incidents of stroke: 1,206 were ischemic strokes, 363 hemorrhagic strokes, and
602 were of an unknown or probable type. An ischemic stroke occurs when blood
flow to the brain is blocked. A hemorrhagic stroke occurs when a blood vessel
bursts in the brain.
Approximately 30
percent of women reported that they never drank alcohol, 35 percent reported
very low levels of consumption, 37 percent drank moderately, and only 11
percent of women reported drinking more than the equivalent of one mixed drink
per day on average.
In the study,
low consumption was considered less than 4.9 grams daily (less than 1/2 glass
of wine per day). Moderate consumption was considered 5 to 14.9 grams daily (1/2
to 1 1/2 glasses of wine, one serving of a mixed drink, or one beer).
After analyzing
the data, the researchers saw that women who consumed low to moderate amounts
of alcohol had a lower risk of total stroke compared to women who never drank.
Higher levels of alcohol intake were not associated with reduced risk of
stroke.
The researchers
speculate on several scenarios that may explain alcohol's ability to reduce
stroke risk. Alcohol may have components to prevent blood clots and cholesterol
from building up in the arteries, both of which can lead to stroke. Higher
levels of alcohol intake may increase the risk of high blood pressure and
atrial fibrillation which are risk factors for stroke.
The study's
findings support the public health message issued by AHA regarding alcohol
consumption. AHA recommends that women and men who consume alcohol should do so
in moderation. This means one drink per day for women and one to two drinks per
day for men. The AHA defines one drink as: one 12-ounce beer, 4 ounces of wine,
11/2 ounces of 80-proof spirits, or 1 ounce of 100-proof spirits. Also, in
light of the study findings, AHA cautions that people who abstain from alcohol
should not start drinking due to the dangers associated with it (e.g.,
alcoholism).
Ischaemic
Stroke Risk Lowest for Moderate Alcohol Consumption
Consuming
alcohol more frequently than twice a week increases the risk of stroke
mortality in men, according to a study carried out at the University of Eastern
Finland. The results show that the effects of alcohol are not limited to the
amount consumed, but also the frequency of drinking matters. The results were
published in Acta Neurologica
Scandinavica.
Excessive
consumption of alcohol is associated with a variety of different diseases. The
relationship between alcohol consumption and ischaemic stroke shows a J curve
pattern, which means that in people who are moderate consumers of alcohol, the
risk of stroke is the lowest, while heavy consumption of alcohol increases the
risk of stroke.
The risk of
cerebral haemorrhage increases linearly as the consumption of alcohol
increases: the higher the amount of alcohol consumed, the higher the risk of
stroke. In addition to alcohol, other significant risk factors for stroke
include elevated blood pressure, coronary artery disease, heart failure, atrial
fibrillation, diabetes, smoking, overweight, asymptomatic carotid artery
stenosis, and elevated cholesterol levels.
The study showed
that people who consume alcohol more frequently than twice a week have over a
threefold risk of stroke mortality than people who do not consume alcohol at
all. The risk of stroke mortality is elevated irrespective of the amount of
alcohol consumed.
The study is
based on follow-up data from the Kuopio Ischaemic Heart Disease Risk Factor
Study, KIHD. At the onset of the study, the men participating in the study were
middle-aged, and the follow-up time was 20 years. A total of 2,609 men
participated in the study.
The consumption
of alcohol was measured with the help of a Nordic alcohol survey charting the
amount of alcohol consumed at one time and the average number of drinking
occasions in the preceding 12 months. The data on cases of stroke was obtained
from hospital discharge registers, the Finnish Stroke Register, and the
National Cause of Death Register maintained by Statistics Finland.
Moderate
drinking and cardiovascular health: beer
Beer could stand
up alongside wine regarding positive effects on cardiovascular health. This is
the conclusion of a study conducted by Research Laboratories at the Fondazione
di Ricerca e Cura "Giovanni Paolo II", in Campobasso, Italy. Both for
wine and beer the key is moderate and regular drinking.
The research,
published online by the European Journal
of Epidemiology, using the statistic approach of meta-analysis, pooled
different scientific studies conducted worldwide in previous years to achieve a
general result. This way it has been possible to examine data concerning over
200,000 people, for whom alcohol drinking habits were associated with
cardiovascular disease.
Results confirm
what was already known about wine: a moderate consumption (approximately two
glasses per day for men and one for women) can lower the risk of cardiovascular
disease, up to 31% less when comparing to non drinkers. What this research adds
are new data on beer. For the first time, in fact, evidence about
dose-dependent effect is shown for this beverage. Maximum protection is
observed, for a beer containing 5% of alcohol, with a consumption of slightly
more than an English pint a day.
"In our
research – explains Simona Costanzo, first author of the paper - we considered
wine and beer separately: you first observe a reduction in cardiovascular risk
with low to moderate drinking. Then, with an increasing consumption, you can
see that the advantage disappears, until the risk gets higher. The interesting
part of our research is that, among the studies selected for this
meta-analysis, there were 12 in which wine and beer consumption could be
compared directly. Using these data we were able to observe that the risk
curves for the two beverages are closely overlapping".
But beer as well
as wine, drinkers, should be cautious before toasting too much at these
results. "What we are talking about – says Augusto Di Castelnuovo, head of
the Statistic Unit of Research Laboratories and a pioneer in alcohol
epidemiological studies - is moderate and regular drinking. I think we will
never stress enough this concept. Wine or beer are part of a lifestyle. One
glass can pair with healthy foods, eaten at proper time, maybe together with
family of friends. There is no place for binge drinking or any other form of
heavy consumption.
"The data
reported in our meta-analysis – Di Castelnuovo emphasizes- cannot be
extrapolated to everybody. In young women still in their fertile age, as an
example, alcohol can slightly raise the risk for some kind of cancer. This
could counterbalance the positive effect on cardiovascular disease and reduce
the overall benefit of alcoholic beverages on health".
In the
similarity between wine and beer regarding positive effects on cardiovascular
health there is a still unanswered question: the evidence we are observing
derives from alcohol alone or from other substances contained in beverages?
Wine and beer are different in composition, except for alcohol, so we could think
this is the main player. But they both contain polyphenols, albeit different
ones. Researchers at Fondazione "Giovanni Paolo II" underline how
this is something to look at more closely in the future.
"A research
like this - comments Giovanni de Gaetano, director of Research Laboratories at
Fondazione "Giovanni Paolo II" – is part of a concept that our group
strongly pursues: to look at people's real life. Health and disease are
conditions deriving from our lifestyle. New therapies, new drugs, are extremely
important. But a healthy life, with a strong attitude toward prevention, is the
key element of the medicine in the years to come".
Reduction in risk of coronary heart disease from
alcohol consumption
In a
prospective, observational study of approximately 150,000 Norwegians, the
investigators found that alcohol consumption was associated with a large
decrease in the risk of death from coronary artery disease. For men, the fully
adjusted hazard ratio for cardiac death was 0.52 (in other words, only about
1/2 the risk of dying) when comparing subjects reporting more than one
drink/week in comparison with those reporting never or rarely drinking; for
women, it was 0.62 (only about 3/5 the risk of dying). There was little change
in the hazard ratio when HDL-cholesterol (HDL) was added to the model,
suggesting that very little of the lower risk of heart disease was due to an
increase in HDL from alcohol consumption.
Forum members
considered this a well-done analysis. They were surprised at the very low
amounts of alcohol intake reported by the subjects, with only 16% of males and
about 8% of females reporting more than one drink/week. It is possible that the
low levels of drinking, or perhaps over-adjustment in the multivariable
analysis, led to the lack of effect of HDL. Most other studies have shown a
much larger proportion of the effect of alcohol on heart disease risk to be
associated with an increase in HDL.
Lower risk of coronary heart disease from alcohol
An analysis
assessesd the 12-month prevalence of coronary heart disease (CHD) in
individuals according to their category of alcohol use. The 2001 National
Epidemiologic Survey on Alcohol and Related Conditions study (the NESARC study,
n = 43,093) identified 16,147 abstinent individuals, 15,884 moderate consumers,
9,578 hazardous drinkers — defined as exceeding sex-specific weekly limits
established by the World Health Organization, and 1,484 alcohol-dependent
subjects. Diagnoses were generated using the Alcohol Use Disorder and
Associated Disabilities Interview Schedule-DSM-IV version.
Both moderate
and hazardous drinking were associated with decreased odds of CHD when compared
with abstinence, whereas odds of CHD were not significantly different between
alcohol-dependent and abstinent participants. A moderate or even a hazardous
consumption of alcohol was associated with a decreased likelihood of CHD after
controlling for socio-demographic, psychiatric, and addictive risk factors. The
study shows that alcohol may have cardio-protective effects not only in
moderate drinkers, but also in individuals with patterns of use traditionally
considered as hazardous.
Effects of alcohol on risk factors for
cardiovascular disease
A summary paper
on the effects of alcohol consumption on biologic mechanisms associated with
coronary heart disease provides an excellent review of a large number of
intervention studies in humans. Appropriate analyses were done and the results
are presented in a very clear fashion, although there was little discussion of
the separate, independent effects of alcohol and polyphenols on risk factors.
The trials the
authors reviewed have demonstrated that the moderate intake of alcoholic
beverages leads to increases in HDL-cholesterol (good cholesterol),
apolipoprotein A1, and adiponectin and decreases in fibrinogen, all factors
associated with a lower risk of heart disease. The findings described in this
paper strengthen the case for a causal link between alcohol intake and a
reduced risk of coronary heart disease, suggesting that the lower risk of heart
disease observed among moderate drinkers is caused by the alcoholic beverage
itself, and not by other associated lifestyle factors.
The reviewers
independently selected studies that examined adults without known
cardiovascular disease and that compared fasting levels of specific biological
markers associated with coronary heart disease after alcohol use with those
after a period of no alcohol use (controls). A total of 4,690 articles were
screened for eligibility, the full texts of 124 studies reviewed, and 63
relevant articles selected. Of 63 eligible studies, 44 on 13 biomarkers were
meta-analysed in fixed or random effects models. Quality was assessed by
sensitivity analysis of studies grouped by design. Analyses were stratified by
type of beverage (wine, beer, spirits).
The authors
concluded that favourable changes in several cardiovascular biomarkers (higher
levels of high density lipoprotein cholesterol and adiponectin and lower levels
of fibrinogen) provide indirect pathophysiological support for a protective
effect of moderate alcohol use on coronary heart disease.
Drinking Alcohol in Moderation Protects Against
Heart Disease
Individuals who
drink alcohol in moderation (about one drink a day or less) are 14-25% less
likely to develop heart disease compared to those who drink no alcohol at all,
finds research led by Professor William Ghali from the University of Calgary,
published online in the British Medical
Journal.
The first paper,
led by Paul Ronksley from the University of Calgary, emphasizes that a balance
needs to be found between the public health message that consuming large
amounts of alcohol is bad for you, and the one that drinking in moderation can
have health benefits.
An accompanying
paper led by Dr Susan Brien, also from the University of Calgary, finds that
moderate consumption of alcohol (up to one drink or 15 g alcohol per day for
women and up to two drinks or 30 g alcohol per day for men) is good for health.
They say moderate amounts of alcohol significantly increase the levels of
'good' cholesterol circulating in the body and this has a protective effect
against heart disease.
Brien and
colleagues argue that their study strengthens the case that there is a causal
link between alcohol consumption and reduced heart disease.
The authors of
both papers acknowledge that a number of previous studies have concluded that
moderate alcohol consumption has been associated with a decrease in heart
disease. However, they say that the research was out-of-date and there was a
need for new material. Professor Ghali says his team's research is the most
comprehensive to date.
Ghali and
colleagues reviewed 84 studies of alcohol consumption and heart disease. They
compared alcohol drinkers with non-drinkers and their outcomes in relation to
heart disease, death from heart disease, incidences of stroke and death from
having a stroke.
In the companion
study, Brien and colleagues reviewed 63 studies and investigated alcohol
consumption with known physical markers for heart disease such as cholesterol,
levels of inflammation, fat cells and the condition of blood vessels. They also
assessed the impact of the type of alcohol consumed (wine, beer and spirits).
Interestingly,
Brien's research concludes that it is the alcohol content that provides the
health benefits not the type of alcoholic beverage (wine, beer or spirits) that
is drunk.
Professor Ghali
concludes that the debate between the impact of alcohol on heart disease should
now centre "on how to integrate this evidence into clinical practice and
public health messages.
Alcohol in moderation is good for sick hearts too
A study by the
Catholic University of Campobasso, Italy, shows that a regular and moderate
alcohol consumption is beneficial for people who had a previous heart attack or
other ischemic vascular events
It was still an
open question in medicine. Whereas scientific research has shown beneficial
effects of moderate alcohol consumption in healthy people, it was not clear
whether this could be valid also for patients who already had heart attack,
stroke or another ischemic vascular event. A positive answer comes now from a
study performed by the Research Laboratories at the Catholic University of
Campobasso, Italy: moderate consumption, defined as one or two glasses of wine
a day or the equivalent amounts of beer or other alcoholic beverages,
significantly reduces the risk of death from any cause in those who already
suffered from ischemic vascular disease.
The research,
published in the Journal of the American
College of Cardiology (JACC), was performed using the statistic procedure
of meta-analysis which allows to combine different studies conducted worldwide
to achieve more precise results. Researchers analyzed the most important
scientific studies performed during the last years. Eight in total in four
Countries: United States, Sweden, Japan and Great Britain. Each study took into
account patients already affected by an ischemic vascular event. During the
years following the disease onset, patients were followed by researchers to
know which were the lifestyle habits, including alcohol consumption, able to
avoid a new clinical event. The meta-analysis allowed to pool all those studies
for a total of 16,351 people examined.
"We
observed – says Simona Costanzo, epidemiologist and first author of the study –
that regular and moderate consumption has beneficial effects even for people
already affected by heart attack, or stroke. Not only they are less likely to
be affected by similar diseases again, but all-cause mortality too resulted to
be lower than in those who did not consume any alcoholic beverage".
The effect is
very similar to that observed in healthy people. "Risk reduction -
Costanzo argues - is about 20%. This means that one event out of five can be
spared. It is a huge advantage, comparable to the one already recorded for
healthy individuals".
"Studied by
our research group for a long time – says Augusto Di Castelnuovo, Head of the
Statistic Unit at the Research Laboratories of the Catholic University in
Campobasso and co-author of the study - the beneficial effects of moderate
alcohol consumption in healthy people are well established. Now we have reason to
believe that alcoholic beverages work by the same protective mechanisms also
for people already affected by ischemic vascular diseases".
But, as all
researches state, the key word is moderation. "When we talk about moderate
alcohol consumption, we mean something quite far from what we use to see in TV
fictions – says Licia Iacoviello, Head of the Laboratory of Environmental and
Genetic Epidemiology and responsible of the Moli-sani Project – We refer to
moderation as drinking regularly, at low doses, within a healthy lifestyle,
such as the Mediterranean diet. A glass of wine or beer during meals has always
been an integral part of the Mediterranean way of eating. Our research
highlights another crucial issue: drinking has not only to be moderate, but
also regular. A moderate consumption spread along the week is positive. The
same amount of weekly alcohol, concentrated in a couple of days is definitely
harmful".
"Despite
these new positive results- argues Giovanni de Gaetano, Director of the
Research Laboratories - we do believe that teetotallers, either healthy or ill,
should not start drinking with the aim to earn more health. Our study, as those
conducted by our group in the past, is not a kind of invitation to start
drinking, but the recognition of a particular lifestyle. This time we need to
be cautious since we deal with sick people. We recommend to them to discuss
with their own doctor the best choice in terms of alcoholic beverage
consumption".
Champagne Is Good for Your Heart
Research from
the University of Reading suggests that two glasses of champagne a day may be
good for your heart and circulation. The researchers have found that drinking
champagne wine daily in moderate amounts causes improvements in the way blood
vessels function.
Champagne does
this by increasing the availability of nitric oxide, a vascular active molecule
which controls blood pressure. It is able to induce these effects because it
contains polyphenols, plant chemicals from the red grapes and white grapes used
in champagne production.
When you drink
champagne, these polyphenols get absorbed into the circulation where they are
able to act on the vascular system. Specifically, they appear to slow down the
natural removal of nitric oxide from our blood, meaning that it will have a
longer time to act on blood vessels and so improve the flow of blood around the
body.
High nitric
oxide levels in the blood, as a result of drinking champagne, can have
beneficial effects, because as well as increasing blood flow, it may help to decrease
both blood pressure and the likelihood of blood clots forming. This could
therefore reduce the risks of suffering from cardiovascular disease and stroke,
but more research needs to be done to determine the long term effects of daily
champagne consumption.
Dr Jeremy
Spencer, from the Department of Food and Nutritional Sciences said: "Our
research has shown that drinking around two glasses of champagne can have
beneficial effects on the way blood vessels function, in a similar way to that
observed with red wine. We always encourage a responsible approach to alcohol
consumption, but the fact that drinking champagne has the potential to reduce
the risks of suffering from cardiovascular diseases such as heart disease and
stroke, is very exciting news."
Light to moderate drinking and socialization are
jointly good for cardiovascular health
While heavy
drinking is associated with a greater risk of stroke, light-to-moderate
drinking has been linked to a lesser risk of ischemic stroke and coronary heart
disease. Other studies have shown that more social support is linked to less
risk of mortality and cardiovascular disease. A Japanese examination of the
effects of social support on the relationship between drinking and
cardiovascular disease has found that the health benefits of light-to-moderate
drinking are more pronounced in men with greater social support.
Results were
published in the June, 2009 issue of Alcoholism:
Clinical & Experimental Research.
"In Japan,
drinking is divided into two main patterns," said Hiroyasu Iso, a
professor of public health at Osaka University and corresponding author for the
study. "One pattern is drinking alone and/or with family at home during
the evening. Another pattern – especially for middle-aged business men – is social
drinking with co-workers, friends, and neighbors. Social drinking is
common."
"Alcohol
can play a key role," concurred Takeshi Tanigawa, a professor in the
department of public health at Ehime University Graduate School of Medicine,
"for socializing as well as some business discussions. In urban areas,
alcohol consumption is often used as a business tool. In rural areas, people
often have a drink with classmates and people in the same community. Alcohol
consumption can be used to maintain human relationships between father and son,
senior and junior, community to community. Collectively, these socializing
customs may help to create a stress-free space for those persons surrounded by
dozens of stresses, especially in the workplace."
"Prior to
our research," said Iso, "no study had examined whether psychosocial
factors modify the association between alcohol consumption and risks of stroke
and coronary heart disease."
Iso and his
colleagues examined 19,356 men 40 to 69 years of age who were enrolled in the
Japan Public Health Center-based Prospective Study. Their alcohol consumption
was classified into seven categories: never, past, occasional, 1-149, 150-299,
300-449, or ≥450 grams/week. Measures used were alcohol consumption, risk of
cardiovascular disease, and social support.
"We found
the reduced risks of total stroke, ischemic stroke, and total cardiovascular
disease associated with light-to-moderate drinking were more pronounced in men
with high social support, probably due to avoidance of unhealthy behaviors and
enhancement of stress buffering," said Iso. "In our study, compared
with light-to-moderate drinkers with high social support, those with low social
support had more unhealthy lifestyles such as physical inactivity, no job and fewer
opportunities for medical checkups. Also, a potential pathway by which poor
social support may lead to cardiovascular disease is mental stress. Mental
stress activates neuro-endocrine components, including the
hypothalamic-pituitary-adrenal-axis and autonomic nervous system, which lead to
an increased risk of cardiovascular disease."
"In
short," said Tanigawa, "moderate to light alcohol consumption with
high social support is good for your health. Drinking with a good friend
appropriately makes you feel happy and healthy. So drink with good friends for
health," he advised. Tanigawa also recommended karaoke bars as one way for
business persons to cope with stress. "Singers use deep breathing, which
is good for the parasympathetic nervous system. After singing, they usually
receive applause. It is a good kind of social support, and helps in the face of
adverse occasions or stressful events."
Iso agreed that
moderate alcohol consumption and socialization is good for one's health.
"But remember that this beneficial effect of social support is confined to
light-to-moderate drinking," he said. "Heavy drinking is risky
irrespective of social support level. We believe that this also holds for other
ethnic populations."
Men who drink alcohol every day have a lower
risk of heart disease
Men who drink
alcohol every day have a lower risk of heart disease than those who drink less
frequently suggests research in the British
Medical Journal. It is widely known that moderate drinkers have a lower
risk of coronary heart disease than those who abstain, but most research in
this field has been done on men and little is known about drinking patterns and
risk of heart disease among women.
Researchers in
Denmark studied over 50,000 men and women aged 50-65 years who were taking part
in a national health study. Details on alcohol intake and drinking frequency
over the preceding year were collected, and participants were monitored for an
average of 5.7 years.
Coronary heart
events were recorded and results were adjusted for known risk factors, such as
age, smoking, education, physical activity and diet.
A total of
28,448 women and 25,052 men took part in the study. Women consumed an average
of 5.5 alcoholic drinks a week and men consumed 11.3. During the study, 749
women and 1,283 men developed coronary heart disease.
Women who drank
alcohol on at least one day a week had a lower risk of coronary heart disease
than women who drank alcohol on less than one day a week.
However, risks
were similar for drinking on one day a week (36% reduced risk), or seven days a
week (35% reduced risk), suggesting that the amount of alcohol consumed is more
important than drinking frequency among women.
In contrast, for
men, risks were lowest for the most frequent drinkers. For example, men who
drank on one day a week had a 7% reduced risk, while men who drank daily had a
41% reduced risk. This suggests that it doesn’t matter how much men drink, as
long as they drink every day.
Moderate drinking lowers women's heart attack risk
Women who
regularly enjoy an alcoholic drink or two have a significantly lower risk of
having a non-fatal heart attack than women who are life-time abstainers,
epidemiologists at the University at Buffalo have shown._
Moderation is
the key, however. Women in the study who reported being intoxicated at least
once a month were nearly three times more likely to suffer a heart attack than
abstainers, results showed.
One difference
in the protective pattern among drinkers involved those who drank primarily
liquor. Women who preferred liquor to wine experienced a borderline increase in
risk of heart attack, results showed.
The study is
published in the May 2007 issue of the journal Addiction.
"These
findings have important implications, because heart disease is the leading
cause of death for women," said Joan M. Dorn, Ph.D., associate professor
of social and preventive medicine in the UB School of Public Health and Health
Professions and first author on the study.
Women seem to
have a quicker reaction to a smaller amount of alcohol, she noted:
"Overdoing it is harmful, and what is too much depends on each individual.
In some women, one drink can cause intoxication."
Moderate alcohol
consumption has been shown to lower the risk of heart attack, but most studies
have been done with men. The current study compared alcohol drinking volume and
drinking patterns of women who had been hospitalized due to a heart attack,
with age-matched controls without heart problems.
Alcohol Can Benefit the Hearts of New Drinkers
A Medical
University of South Carolina’s (MUSC) Department of Family Medicine study
concluded that people who began moderately consuming alcohol in middle-age
experience a quick benefit of lower rates of cardiovascular disease morbidity
with no change in mortality after four years. In addition, the study found that
those who consumed alcohol for the heart health benefits rarely drank more than
recommended amounts. The study has been published in the American Journal of Medicine, and was conducted by MUSC’s Dana E.
King M.D., Arch G. Mainous III, Ph.D, and Mark E. Geesey.
“Most people are
aware that moderate alcohol use can be part of a healthy lifestyle, yet current
guidelines caution non-drinkers against starting to drink in middle age,” said
King, lead author of the study. “We wanted to evaluate whether adopting
moderate alcohol consumption in middle-age would lower cardiovascular risk. We
were excited to find that moderate alcohol consumption, or one to six servings
a week, lowered cardiovascular risk for our participants.”
In contrast to a
recently published study in the British Public Library of Science journal, PLoS Medicine, MUSC’s study showed no
increase in blood pressure for participants at moderate consumption levels (two
drinks per day or fewer for men, one drink per day or fewer for women) during
the four years of the study. New moderate drinkers had a 38% lower chance of
developing cardiovascular disease than did their persistently non-drinking
counterparts. This difference remained after adjustment for demographic and
cardiovascular risk factors.
Alcohol’s impact on heart and stroke risk
may differ for men, women
The volume of
alcohol consumption may have a significantly different effect on heart and
stroke risk in men and women, according to a study of Japanese people published
in Stroke: Journal of the American Heart
Association.
“An amount of
alcohol that may be beneficial for men is not good for women at all,” said
Hiroyasu Iso, M.D., co-author of the study and professor of public health at
Osaka University in Japan.
Researchers
analyzed data from a survey of 34,776 men and 48,906 women (ages 40 to 79)
selected from the larger Japan Collaborative Cohort Study (JACC) to determine
the association of alcohol use with the risks of stroke and heart disease.
Participants who had not experienced cancer, stroke or heart disease before the
study completed questionnaires about their lifestyles and medical histories and
provided information about their drinking of sake (rice wine), shochu (a type of
brandy), beer, whiskey and/or wine.
Researchers
calculated the risks and benefits of alcohol consumption after adjusting for
age and several other risk factors, including smoking, weight, body mass index,
the presence of high blood pressure or diabetes, exercise habits, stress,
education and diet.
During a
14.2-year follow-up, 1,628 participants died from stroke and 736 died from
heart disease.
Men who reported
drinking heavily (at least 46 grams of alcohol per day, equivalent to four or
more standard alcoholic beverages) at the time of the survey had a 19 percent
lower risk of dying from coronary heart disease than nondrinking men.
In stark
contrast, women who drank that much quadrupled their risk of heart disease
death over that of nondrinking women. Light drinking (less than 23 grams of
alcohol per day, about two drinks a day) reported on the survey was associated
with a lower risk of heart disease death in women by 17 percent; while intake
between 23 and 46 grams per day was associated with an increased risk of 45
percent.
“In women, we
found a slightly reduced risk with light consumption but a much greater risk
with heavy alcohol use,” Iso said.
In men, heavy
alcohol use was associated with an increased risk of death from all types of
stroke by 48 percent. The risk of hemorrhagic stroke (caused by a blood vessel
bursting in the brain) was increased 67 percent. The risk of ischemic stroke
(caused by a blocked blood vessel in the brain or leading to it) was higher by
35 percent.
In women, heavy alcohol
use was associated with a higher risk of stroke death by 92 percent.
Hemorrhagic stroke death risk was increased by 61 percent. The risk of ischemic
stroke death was increased 2.43 times.
“We expected to
find an increased risk of hemorrhagic stroke,” Iso said. “But since alcohol
reduces the ability of the blood to clot, we didn’t expect to find the
increases in ischemic stroke and coronary heart disease.”
Only 15 percent
of women in JACC drank any alcohol, far less than the 45.9 percent of U.S. women
who reported using alcohol in 2005, Iso said.
Before this
study, evidence suggested that light-to-moderate alcohol consumption might be
associated with a lower risk of cardiovascular disease in women. But data on
heavy drinking was limited and the question had not been addressed in an Asian
country, where both drinking and heart disease are less common.
“One limitation
of the study is that, in Japanese culture, there are social restrictions
against women drinking as they get older,” Iso said. “In that culture, the
women who do drink may have different types of jobs or other aspects of their
lifestyle that may help explain the excess risk as well as the alcohol exposure
itself.”
Iso said more
research could help determine how alcohol affects cardiovascular risk.
The American
Heart Association does not recommend drinking wine or other forms of alcohol,
since there is clear evidence that alcohol use is associated with injury to the
heart in many ways. Instead, the association recommends that people talk to
their doctor about lowering their cholesterol and blood pressure, controlling
weight, getting enough physical activity and following a healthy diet and
quitting smoking. There is no scientific proof that drinking alcoholic
beverages can replace these conventional measures.
A little wine boosts omega-3 in the body:
Researchers find a novel mechanism for a healthier heart
Results from the
European study IMMIDIET show that moderate wine intake is associated with
higher levels of omega-3 fatty acids considered as protective against coronary
heart disease
Moderate alcohol
intake is associated with higher levels of omega-3 fatty acids in plasma and
red blood cells. This is the major finding of the European study IMMIDIET
published in the American Journal of
Clinical Nutrition, an official publication of the American Society for
Nutrition and is already available on line (www.ajcn.org ). The study suggests
that wine does better than other alcoholic drinks. This effect could be
ascribed to compounds other than alcohol itself, representing a key to
understand the mechanism lying behind the heart protection observed in moderate
wine drinkers.
The IMMIDIET
study examined 1,604 citizens from three geographical areas: south-west London
in England, Limburg in Belgium and Abruzzo in Italy. Thanks to a close
cooperation with General Practitioners of these areas, all participants
underwent a comprehensive medical examination, including a one year recall food
frequency questionnaire to assess their dietary intake, alcohol consumption
included.
Omega-3 fatty
acids, mainly derived from fish, are considered as protective against coronary
heart disease and sudden cardiac death, thus their high blood concentration is
definitely good for our health.
Now European
researchers found that moderate alcohol drinking acts like a 'trigger',
boosting the amount of omega-3 fatty acids in our body.
"Several
studies have shown that moderate alcohol consumption, including wine, is
associated with protection against coronary heart disease and ischemic stroke -
says Romina di Giuseppe, lead author of the study, from the Research
Laboratories at Catholic University of Campobasso - Although the mechanisms are
not completely defined, there was some evidence that alcohol intake might
influence the metabolism of essential polyunsaturated fatty acids, as omega-3.
That is exactly what we found in our population study. People drinking moderate
amounts of alcohol, one drink a day for women and two for men, had higher
concentration of omega-3 fatty acids in plasma and red blood cells
independently of their fish intake".
However
important these results appear to be, the best is yet to come. Researchers from
Catholic University of Campobasso, in Italy, and from University of Grenoble,
in France, turned their attention on the variety of alcoholic beverages
consumed in order to see whether the high levels of omega-3 fatty acids
detected might be ascribed to alcohol itself or to other substances.
"From our
previous studies we know that association between wine drinking and increased
concentration of omega-3 fatty acids have been observed – says Michel de
Lorgeril, from the University of Grenoble, partner of the IMMIDIET project and
co-leader of the study - Nevertheless, it was not possible to separate the effects
of wine from those of beer or spirits. Our study of 3 populations with
different dietary habits and different consumption of alcoholic beverages types
allowed us to explore this aspect.".
"Analysis
carried out on different alcoholic beverages –argues Licia Iacoviello
coordinator of the IMMIDIET study at Catholic University of Campobasso - showed
that the association between alcohol and omega-3 fatty acids was present in
both wine drinkers and beer or spirits drinkers. However, the association was stronger
between wine drinking and omega-3 fatty acids levels. This suggests that
components of wine other than alcohol is associated with omega-3 fatty acids
concentration. We may guess this effect can be ascribed to polyphenols".
Polyphenols are
naturally occurring compounds contained in a different variety of food and
beverages, such as wine. Due to their strong antioxidant activity, they are
able to reduce oxidation processes caused by free radicals.
"We
consider these data to be a major finding - de Lorgeril concludes - opening a
new window in the field of cardiovascular prevention. Beyond the alcohol issue,
our results raise crucial questions regarding the effects of polyphenols on
lipids (both in blood and cell membranes) and possibly of lipids on polyphenols".
The IMMIDIET
study
Funded by the
European Union under Key Action 1: Food, Nutrition and Health
QLK1-CT-2000-00100, IMMIDIET aims to acquire fundamental knowledge in the field
of cardiovascular disease, especially regarding the interaction between
genetics and lifestyle.
At the core of
the study there is an important episode of Italian migration: Belgium, a
country that became the new home for thousands of Italians, mostly from the
Abruzzo region, who came to work in the mines. Many of those emigrants didn't
come back to Italy but remained in their new country. Some of them married a
Belgian partner. Their genes remained the same, of course, but how much
"Italy" is still there in their diet? And how much did they transmit
it to their spouses? Moreover, how many Italian emigrants assimilate dietary
habits of the country in which they were guests? In this framework, the role of
genetic factors and lifestyle can be assessed to explore new ways in prevention
of cardiovascular diseases.
To carry on the
research, married couples have been recruited in three European areas:
South-East London in England, Limburg in Belgium and Abruzzo in Italy. In the
first phase of the study the couples involved were formed by people from the
same area, Italians married with Italians (in the Abruzzo region), Belgians
married with Belgians (in the Limburg area) and English married with English
(in the South-East part of London)".
The second phase
of IMMIDIET recruited mixed Italian–Belgian couples to understand if, acquiring
dietary habits from Abruzzo, the Belgian partner changed his own risk regarding
heart diseases.
Alcohol & polyphenols in red wine both fight
cardiovascular disease
Observational
epidemiologic studies relating wine and alcohol to health all suffer from the
fact that they, of necessity, compare people who prefer certain beverages, but
not the beverages themselves. While there have been many intervention trials in
animals, randomized trials in humans are less common. Randomized crossover
trials, in which each subject receives all interventions in sequence, can be
especially important as they tend to avoid baseline differences among subjects
and can detect effects of different interventions with smaller numbers of
subjects.
This study
published in the American Journal of
Clinical Nutrition, included 67 male volunteers in Spain who were
considered to be at "high-risk" of cardiovascular disease on the
basis of increased BMI, smoking, diabetes, hypertension, or other risk factors.
About one half of the individuals were taking ACE inhibitors, statins, aspirin,
and/or oral hypoglycemic drugs, so the results of this study may be especially
relevant for patients in the real world.
The subjects
agreed to not consume any alcohol for a baseline period, then for three
one-month periods consumed 30 g/day of alcohol as red wine or as gin, or an
equivalent amount of phenolics from dealcoholized red wine. The polyphenol
contents of the RW and the DRW interventions were the same. A very high degree
of compliance of the subjects with the assigned interventions is evidenced by
results of counting numbers of empty bottles of the intervention beverage
returned, dietary records, urinary metabolites, etc. Further, there is good
evidence that there were no important changes between periods in diet or
exercise habits. The effects of each intervention on a large number of adhesion
molecules and chemokines that affect inflammation and relate to the development
of vascular disease were evaluated.
The key results
of the study were that both ethanol and nonalcoholic compounds in red wine have
potentially protective effects that may reduce the risk of vascular disease.
Specifically, the authors conclude that "the phenolic content of red wine
may modulate leukocyte adhesion molecules, whereas both ethanol and polyphenols
of red wine may modulate soluble inflammatory mediators in patients at high
risk of cardiovascular disease."
Specific
comments on the study: Most reviewers considered this to be a well-done,
comprehensive study. As one reviewer commented: "This is an excellent
paper. The results strongly indicate an effect of wine polyphenols on
inflammation (in broad and modern terms) and this is just what we expect from
the biochemistry and nutritional effects of fruits and vegetables. The effect
of ethanol, on the other hand, likely fits a hormetic mechanism, where low
doses regularly supplied are protective while high doses in a single shot are
worsening the progression of disease." Another reviewer added: "We
need more information on separating the effects of beer, wine, and various
types of spirits. Some spirits like brandy and whisky can have useful
antioxidant effects, so distinguishing effects among different types of
beverages may be informative."
Another Forum
reviewer commented: "This is a very interesting paper that goes a way
towards answering the question whether it is the alcohol or polyphenols in red
wine that confer the health benefits. The trial was well conducted and
controlled, with very detailed analyses. It would have been interesting to
analyse any changes in conventional risk factors after the interventions. It
would also have been interesting in the study to determine the effects on
vascular function by, for example, brachial artery activity (flow mediated
dilatation)."
Given that the
effects of both alcohol and polyphenols on physiologic factors (e.g., platelet
function, fibrinolysis) are transient, generally lasting for no more than 24
hours, it was appropriate that the subjects in this study were instructed to consume
the intervention substance (RW, gin, DRW) on a daily basis. When drinking is
moderate, there is no evidence that having "alcohol-free days" is
beneficial to health. Indeed, most epidemiologic studies show better health
effects from daily consumption rather than from drinking on a few days per
week.
Concerns about
the present study: One Forum reviewer stated: "This appears to be a
carefully designed and well executed study, but I have four concerns: (1) The
study has been undertaken in high-risk individuals, more than half of whom are
hypertensive, a quarter dyslipidaemic, and a quarter diabetic. It is not
described what happened to the conventional risk factors during the
interventions. (For example, any improvement in inflammatory markers may have come
at the cost of higher blood pressure with the alcohol interventions.) (2) Was
there any weight change that could have confounded any of the outcomes? (3)
Both polyphenol and alcohol biomarkers were measured – did the change in these
biomarkers correlate with the changes in any of the inflammatory markers; i.e.,
any suggestion of a dose response relationship? (4) Even though at least 30
outcome variables were assessed, the authors do not describe any correction for
multiple comparisons."
Another Forum reviewer:
"This is a well conducted study, and adds to our understanding of the
potential cardiovascular benefits of alcohol and the non-alcoholic compounds of
alcoholic beverages. However, in this study more than one-half of the high-risk
subjects consumed drugs with known anti-inflammatory effects, which could be a
confounding factor. The anti-inflammatory effects of these pharmaceuticals may
be responsible for the beneficial results, and may not be related to the RW,
DRW and gin interventions." However, others think that this concern is
unlikely to be important since this was a crossover study, and there were no
changes in lifestyle or medication use between the intervention periods.
The key results
of the study were that both ethanol and nonalcoholic compounds in red wine have
potentially protective effects that may reduce the risk of vascular disease.
Specifically, the authors conclude that "the phenolic content of red wine
may modulate leukocyte adhesion molecules, whereas both ethanol and polyphenols
of red wine may modulate soluble inflammatory mediators in patients at high
risk of cardiovascular disease." Thus, this study provides important new
mechanistic evidence that the reduced risk of cardiovascular disease among red
wine drinkers observed in most epidemiologic studies may result from a
combination of both the alcohol and the polyphenols in the wine.
Moderate Alcohol Consumption Reduces the Risk of
Hypertension for Women, Increases It For Men
Drinking too
much alcohol can raise BP to unhealthy levels, especially among men. Moderate
amounts of alcohol actually protect women, but not men. The meta-analysis
evaluated a total of 16 prospective studies, which included 158,142 men and
314,258 women. Among men, a linear dose–response relationship between alcohol
intake and risk of development of hypertension was noted. As compared to
non-drinkers, men consuming < 10g/day of alcohol had a relative risk (RR) of
1.006, those consuming 10-20 g/day had a RR of 1.091, and those consuming >
30g/day had a RR of 1.416.
Among women, the
meta-analysis indicated protective effects at < 10g/day (RR -0.867) and
10-20g/day (RR – 0.904) of alcohol consumption, while the risk increased in
women consuming > 30g/day (RR – 1.188). The risk of hypertension
significantly increases with consumption of more than 30g/day in men and women
alike.
Note: 30 grams
is equal to about 2 5oz. glasses of wine, or 2 12 oz. beers:
12 ounces beer = 153 calories and 13.9
grams alcohol
12 ounces lite beer = 103 calories and 11
grams alcohol
5 ounces wine (red) = 125 calories and 15.6
grams alcohol
5 ounces wine (white) = 121 calories and
15.1 grams alcohol
3 ounces sake = 117 calories and 14.1 grams
alcohol
1 1/2 ounces liquor (80 proof or 40%
alcohol) = 97 calories and 14 grams alcohol
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