Drinking Alcohol in Moderation Improves Heart Health and Reduces Risk of Heart Attacks and Cardiovascular Disease

Medical research has demonstrated a strong relationship between moderate alcohol consumption and reduction in cardiovascular disease in general and coronary artery disease in particular. 1

On the basis of its extensive review of research, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that moderate drinking is beneficial to heart health, resulting in a sharp decrease in heart disease risk (40%-60%). 2 (See Appendix) This is important because cardiovascular disease is the number one cause of death in the United States and heart disease kills about one million Americans each and every year. 3

The Director of the National Institute on Alcohol Abuse and Alcoholism wrote that "Numerous well-designed studies have concluded that moderate drinking is associated with improved cardiovascular health," and the Nutrition Committee of the American Heart Association reported that "The lowest mortality occurs in those who consume one or two drinks per day." 4 (See Appendix) A World Health Organization Technical Committee on Cardiovascular Disease asserted that the relationship between moderate alcohol consumption and reduced death from heart disease can no longer be doubted. 5

Moderate drinkers are less likely to suffer heart attacks than are abstainers or heavy drinkers.

  • • Harvard researchers have identified the moderate consumption of alcohol as a proven way to reduce coronary heart disease risk. 6
  • • An exhaustive review of all major heart disease studies found that "Alcohol consumption is related to total mortality in a U-shaped manner, where moderate consumers have a reduced total mortality compared with total non-consumers and heavy consumers." 7
  • • A National Institute on Alcohol Abuse and Alcoholism study asserts that "The totality of evidence on moderate alcohol and CHD (coronary heart disease) supports a judgment of a cause-effect relationship... there are cardioprotective benefits associated with responsible, moderate alcohol intake." 8
  • • An extensive review of recent medical research by the National Institute on Alcohol Abuse and Alcoholism found that, with few exceptions, studies from at least 20 countries around the world demonstrate a 20- to 40-percent lower coronary heart disease CHD incidence among drinkers compared to nondrinkers. Moderate drinkers exhibit lower rates of CHD-related mortality than either heavy drinkers or abstainers. 9
  • • A study of 18,455 males from the Physicians Health Study revealed that those originally consuming one drink per week or less who increased their consumption to six drinks per week or less has a 29% reduction in CVD risk compared to those who did not increase their consumption. Men originally consuming 1-6 drinks per week who increased their consumption moderately has a 15% decrease in CVD risk compared to those who made no change. 10
  • • The Harvard Health Professionals Follow-Up Study of over 44,000 males found moderate alcohol consumption to be associated with a 37% reduction in coronary disease. 11
  • • A British study of women found moderate consumption of alcohol to be associated with lower levels of cardiovascular risk factors. 12
  • • A study of over 5,000 women with type 2 diabetes mellitus by Harvard researchers found that coronary heart disease rates "were significantly lower in women who reported moderate alcohol intake than in those who reported drinking no alcohol." Women who drank more than 5 grams (about half a glass) a day reduced their risk of CHD (fatal or nonfatal) by more than half. 13
  • • In a study of nearly 88,000 men, Harvard researchers found that drinking reduced risk of coronary heart disease risk among both diabetics and non-diabetics. Weekly consumption of alcohol reduced CHD risk by one-third (33%) while daily consumption reduced the risk by over half (58%) among diabetics. For non-diabetics, weekly consumption reduced CHD risk by 18% while daily consumption reduced the risk by 39%. 14
  • • Light to moderate consumption of alcohol appears to reduce the risk of coronary heart disease by as much as 80% among individuals with older-onset diabetes, according to a study published in the Journal of the American Medical Association. 15
  • • The Honolulu Heart Study found a 49% reduction in coronary heart disease among men who drink alcohol in moderation. 16
  • • Harvard researchers concluded about coronary heart disease that "Consumption of one or two drinks of beer, wine, or liquor per day has corresponded to a reduction in risk of approximately 20-40%." 17
  • • At a scientific conference, researchers from Korea, Italy, Germany, Poland, the Netherlands, and the United States reported striking reductions in death among moderate drinkers, with heart disease and total mortality rates about one half or less compared to non-drinkers. 18
  • • After over 6,000 participants in the Framingham Heart Study were followed for a period of six to ten years, researchers found that "when consumed in moderation, alcohol appears to protect against congestive heart failure." 19
  • • After reviewing the research, Dr. David Whitten reported that "The studies that have been done show pretty clearly that the chances of suffering cardiac death are dramatically reduced by drinking" one or two drinks a day and asserted that "We don't have any drugs that are as good as alcohol." 20
  • • Based on the medical evidence, noted investigator Dr. Curtis Ellison asserted that "abstinence from alcohol is a major risk factor for coronary heart disease." 21
  • • The American Heart Association, based on the research evidence, concludes that the "Consumption of one or two drinks per day is associated with a reduction in risk of (coronary heart disease) approximately 30% to 50%." 22

The Moderate Consumption of Alcohol Increases the Survivability of Heart Attacks

Drinking alcohol in moderation throughout the year before an acute myocardial infarction (AMI) has been found to reduce the risk of dying afterward. Information on the prior drinking behaviors of about 1,900 patients was collected during their hospitalization for AMI. Deaths of participants were then monitored over the next four years. After adjusting for age, sex and other factors, investigators found that light and moderate drinkers had lower death rates than patients who abstained. Moderate drinkers had the lowest mortality rate, reducing their risk by 32%, compared to abstainers. The health benefits were virtually identical for beer, distilled spirits, and wine. 23

Men who consume two to four drinks of alcohol after a heart attack are less likely to experience a second heart attack than are abstainers, according to a study of 353 male heart attack survivors. Researchers found that men who consumed an average of two drinks of alcohol per day were 59% less likely than non-drinkers to have another heart attack. Those who drank an average of four drinks per day experienced a risk reduction of 52% compared to abstainers. 24

Drinking alcohol (beer, wine, or distilled spirits) in moderation reduces the damage to effected tissue following a heart attack, according research by Dr. Ron Korthuis, Distinguished Professor and Chair of the Department of Medical Pharmacology and Physiology at the University of Missouri-Columbia. 25

*Among men who have had previous heart attacks, "moderate alcohol intake was associated with a significant decrease in total mortality," with those drinking two to six drinks a week at the lowest risk for dying compared to nondrinkers.

The study of over 85,000 men for a five year period used data from the Harvard University Physicians' Health Study. 26

Alcohol Abstainers Who Begin Drinking Reduce Their Risk of Cardiovascular Disease

*Researchers at the Medical University of South Carolina have found that middle-aged non-drinkers who began drinking in moderation experienced a 38% lower risk of developing cardiovascular disease compared to those who continued abstaining.

The medical researchers studied 7,697 people between 45 and 64 who were non-drinkers and who were participating in the Atherosclerosis Risk in Communities (ARIC) study over a 10 year period. The investigators found that 6% began consuming alcohol in moderation (up to one drink per day for women and up to two drinks per day for men) during the follow-up period. After 4 years of follow-up, new moderate drinkers had a 38% lower chance of developing cardiovascular disease than did the non-drinkers. Even after adjusting for physical activity, Body Mass Index, demographic and cardiac risk factors, this difference persisted.

A standard drink is:

  • A 12-ounce bottle or can of regular beer
  • A 5-ounce glass of wine
  • A one and 1/2 ounce of 80 proof distilled spirits (either straight or in a mixed drink)

The alcohol content of a standard drink of beer, dinner wine, or distilled spirits is equivalent. To a breathalyzer, they are all the same.

The health benefits associated with drinking in moderation are also similar for beer, wine and spirits. The primary factor associated with health and longevity appears to be the alcohol itself.

This study is important in that it provide more evidence that the reduced risk of cardiovascular disease among moderate drinkers is a result of the alcohol itself rather than any differences in lifestyle, genetics, or other factors. 27

* Similarly, the Physicians Health Study of 18,455 men revealed that those originally consuming one drink per week or less who increased their consumption to six drinks per week or less has a 29% reduction in CVD risk compared to those who did not increase their consumption. Men originally consuming 1-6 drinks per week who increased their consumption moderately has a 15% decrease in CVD risk compared to those who made no change. 28

Frequent Drinkers Enjoy Greater Heart-Health Benefits than Those Who Drink Less Often

In a study of nearly 88,000 men, Harvard researchers found reductions in coronary heart disease risk with increasing intake of alcohol for both diabetics and non-diabetics.

Weekly consumption of alcohol reduced CHD risk by one-third (33%) while daily consumption reduced the risk by over half (58%) among diabetics. For non-diabetics, weekly consumption reduced CHD risk by 18% while daily consumption reduced the risk by 39%. 29

Exercising Can't Replace Benefits of Drinking in Moderation

Researchers at the National Institute of Public Health in Denmark studied about 12,000 men and women over a period of 20 years.

Moderate Drinking vs. Lifestyle

Why drink to reduce the risk of heart disease? Wouldn't eating a good diet, exercising, and losing weight do the same thing? No, it wouldn't. The moderate consumption of alcohol appears to be more effective than most other lifestyle changes that are used to lower the risk of heart and other diseases. For example, the average person would need to follow a very strict low-fat diet, exercise vigorously on a regular basis, eliminate salt from the diet, lose a substantial amount of weight, and probably begin medication in order to lower cholesterol by 30 points or blood pressure by 20 points.

But medical research suggests that alcohol can have a greater impact on heart disease than even these hard-won reductions in cholesterol levels or blood pressure. Only cessation of smoking is more effective.

Additionally, other medical research suggests that adding alcohol to a healthful diet is more effective than just following the diet alone. 31

The medical investigators found:

  • The lowest risk of fatal heart disease occurred among those who both drank moderately and exercised. They had a 50% reduced risk compared to non-drinkers who didn't exercise. (Moderate drinking was defined as consuming an average of up to two drinks per day for both men and women. This is twice as high as the US federal recommendation for women.)
  • A higher risk was found among (a) those who abstained from alcohol but exercised and (b) those who drank in moderation but didn't exercise. In both cases the risk of heart disease dropped about 30% compared to abstaining non-exercisers.
  • The highest risk was found among those who neither drank nor exercised. Their risk of dying from heart disease was twice as high as those who drank moderately and exercised.

Moderate drinking and exercise are cumulative in their positive effects on the cardiovascular system. Doing one is better than nothing, but doing both is the best choice of all and dramatically reduces the risk death from heart attack. The same is also found for all-cause mortality. 30

How Alcohol Promotes Good Heart Health

The moderate consumption of alcohol promotes good heart health in a number of ways, including the following:

  • Alcohol improves blood lipid profile 32
  • It increases HDL ("good") cholesterol 33
  • It decreases LDL ("bad") cholesterol 34
  • It improves cholesterol (both HDL and LDL) particle size 35
  • Alcohol decreases thrombosis (blood clotting)
  • It reduces platelet aggregation 36
  • It reduces fibrinogen (a blood clotter) 37

    Standard Drinks and Alcohol Equivalence

    Learn what they are and why they'’re very important.

  • It increases fibrinolysis (the process by which clots dissolve) 38
  • Alcohol acts through additional ways 39
  • It reduces coronary artery spasm in response to stress
  • It increases coronary blood flow 40
  • It reduces blood pressure 41
  • It reduces blood insulin level 42
  • It increases estrogen levels 43

Summary

The scientific medical consensus is that the moderate consumption of alcohol, unless contraindicated by alcoholism or other reasons, leads to better heart health and longer longevity than either abstaining from alcohol or abusing it.

Note: This website is informational and educational only. It does not provide health or medical advice or opinion and none should be inferred.

Appendix

Alcohol Reduces Coronary Heart Disease Says U.S. Government

An extensive review of medical research by the National Institute on Alcohol Abuse and Alcoholism found that, with few exceptions, studies from at least 20 countries in North America, Europe, Asia and Australia demonstrate a 20- to 40-percent lower coronary heart disease incidence among drinkers compared to nondrinkers. And moderate drinkers exhibit lower rates of CHD-related mortality than either heavy drinkers or abstainers.

Of the many studies reviewed, one included 276,800 men and the other included 490,000 men and women. 44

Drinking Alcohol Protective against Coronary Heart disease Says American Heart Association

The American Heart Association has reported that

More than a dozen prospective studies have demonstrated a consistent, strong, dose-response relation between increasing alcohol consumption and decreasing incidence of CHD. The data are similar in men and women in a number of different geographic and ethnic groups. Consumption of one or two drinks per day is associated with a reduction in risk of approximately 30% to 50%. 1

Studies of coronary narrowings defined by cardiac catheterization or autopsy show a reduction in atherosclerosis in persons who consume moderate amounts of alcohol. In general, the inverse association is independent of potential confounders, such as diet and cigarette smoking. Concerns that the association could be an artifact due to cessation of alcohol consumption in persons who already have CHD have largely been disproved. 2 No clinical trials have been performed to test the alcohol-CHD relation. However, the large numbers of observational studies support a true protective effect of moderate consumption of alcohol. 45

The important message from the American Heart Association about alcohol and coronary heart disease risk is that the "Consumption of one or two drinks per day is associated with a reduction in risk of approximately 30% to 50%."

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