Author: Gary Jackson

Facts about alcohol and heart health

A study analyzing data of the 2005 US National Alcohol Survey, including 4083 individuals, evaluated the association between current drinking status and early life drinking patterns with three health conditions, including hypertension. They described an increased risk for hypertension in lifetime abstainers and a reduced risk in the less-heavy consumption group; nonetheless, when adjusted by a propensity score method, these findings were not significant. Current drinkers who drink 5 or more drinks/day at least monthly did show a significant risk of hypertension, meaning that consistent long-term heavy drinking is the real cause [60]. Data derived from systematic reviews and meta-analyses suggest that alcohol-dose and CV-health relationships differ for various CV conditions. For example, certain levels of alcohol consumption that lower risk for CHD may increase it for other CV conditions, such as stroke.

• If it’s more than recommended, try to consciously pace your drinking to help reduce the spike in your blood pressure that excessive alcohol causes.
• Other ethanol-induced changes may be related to enzymes that modulate protein synthesis and/or breakdown (e.g., ubiquitine-ligases).

Another trend in recent studies of alcohol and CV risk and disease is to include a measurement for binge drinking. In most investigations, this means consuming more than 5 standard drinks on a single occasion for men and more than 4 standard drinks for women. NIAAA defines binge drinking as a pattern of drinking alcohol that brings the blood alcohol concentration to 0.08 percent or above. A typical adult consuming the defined number of standard drinks for binge drinking would reach a blood alcohol concentration of 0.08 in about 2 hours (NIAAA 2015b). Finally, Baliunas et al. published a meta-analysis of 20 cohort studies evaluating the relationship between alcohol consumption and T2D. They concluded that moderate alcohol consumption is protective for T2D in men and women [80].

Other medical conditions

For example, in one study, the ejection fraction decreased by 4 percent after alcohol consumption (Delgado et al. 1975). Most likely, the decrease in contractility was offset by corresponding decreases in afterload (end-systolic wall stress), systemic vascular resistance, and aortic peak pressure, which maintained cardiac output. The effect of the quantity of alcohol on hypertension according to the frequency of drinking is not yet clear, since studies remain contradictory.

Findings have been equivocal for other lipids, such as low-density lipoprotein cholesterol (LDL-c) (the estimated amount of cholesterol within LDL particles, or “bad cholesterol”) and triglyceride levels (Rimm et al. 1999; Volcik et al. 2008; Waskiewicz and Sygnowska 2013). High triglyceride levels in the blood stream have been linked to atherosclerosis and, by extension, increased risk of CHD and stroke. However, in a recently conducted Mendelian randomization study, Vu and colleagues (2016) reported that low-to-moderate alcohol consumption reduced triglyceride and LDL-c and increased HDL-c, in particular the HDL2-c subfraction.

Alcohol Consumption and Total Stroke Incidence and Prevalence

Evidence from epidemiological studies has been corroborated by intervention studies in humans. For example, Mori et al. carried out a randomized controlled trial evaluating BP changes in 24 premenopausal women at three drinking levels (alcohol free, low volume, and high volume) during a 4-week period each. SBP and DBP were higher in women who consumed greater amounts of alcohol (2–3 drinks per day) compared with the other two drinking levels. However, lower amounts of intake did not show the BP-lowering effects evidenced in other studies [62]. The cardiovascular health effects of alcohol have classically been described as having a J-shaped curve, in which low-to-moderate consumers present less risk than lifetime abstainers, and heavy drinkers show the highest risk [5,19,20,22,23,24,25]. Alcohol intake benefits not only healthy individuals, but also patients with established CVD [3,5].