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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."
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