Research shows that drinking alcohol improves heart attack survival. This is true of drinking both before and after a heart attack.
I. Heart Attack Survival
This isn’t surprising. Drinking alcohol in moderation improves heart health. It also reduces the risk of cardiovascular diseases. This includes heart attacks. That is, myocardial infarctions (MI) or acute myocardial infarctions (AMI).
Studies
Here are some of the many studies on drinking alcohol and heart attack survival.
1. Harvard medical researchers investigated alcohol consumption, previous drinking, and prognosis after heart attack.
They studied 1,346 patients age 45-70 after they experienced a non-fatal heart attack. For over eight years they followed the patients. The scientists recorded alcohol consumption at the time of the attack as well as five years before that time. They recorded recurrent hospitalization for non-fatal heart attack, stroke or heart failure. And they noted cardiac mortality as well as total mortality.
The doctors compared abstainers, moderate drinkers and heavy drinkers. The lowest risk for a second attack or death was for those having one to three drinks per day. The risk of hospitalization for recurrent non-fatal heart attack, stroke, or heart failure generally showed a similar pattern.1
2. Research also suggests that moderate alcohol consumption can aid already-diseased hearts in men.
Researchers studied over 85,000 men for five years. The data came from the Harvard University Physicians’ Health Study.
Among men who have had previous heart attacks, “moderate alcohol intake was associated with a significant decrease in total mortality.” Those drinking two to six drinks a week had the lowest risk for dying compared to nondrinkers.
The researchers also reported that the younger subjects experienced the same health benefits from alcohol as the older subjects.2
Later Heart Attacks
3. Doctors looked at drinking before and after heart attacks. They wanted to know its effects on both later heart attacks and all causes among men who survived heart attacks.
The doctors followed 51,529 male health professionals over time. A total of 1,818 suffered from non-fatal heart attacks. They calculated long-term average alcohol consumption at the the time just before the attack. They then updated average consumption every four years afterward.
The subjects were compared to non-drinkers. Those who had up to about about 2/3 of a glass of alcohol per day averaged a 22% reduction in all-cause mortality. Those who had up to two glasses per day showed a 34% drop in risk. And those drank over two glasses per day had a 13% reduced risk of death from any cause.
The doctors then looked at cardiovascular mortality. The corresponding drops in risk of death were 26%, 42%, and two percent.
Long-term moderate drinking reduced the risk of death. And it did so for both heart attack and death from any cause among men who survived a first heart attack.3
4. Drinking in moderation throughout the year before a heart attack appears to increase heart attack survival over time.
Doctors collected information on the prior drinking behaviors of 1,913 patients. This was done during their hospitalization for a heart attack. Then the doctors monitored the deaths of the patients over the next four years.
The investigators adjusted for age, sex and other relevant factors. 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. They also found that the health benefits were the same for beer, distilled spirits, and wine.4
All-cause Death
5. Doctors made a follow-up study of 5,447 patients diagnosed with vascular disease or diabetes. They did so after 4.7 years to determine the effects of drinking alcohol.
Among patients who consumed 10-20 drinks per week, the risk of coronary heart disease dropped about 60%. And the risk of stroke fell 33%, compared to non-drinkers.
Moderate drinking greatly reduced the risk of amputation, vascular death, and all-cause death. However, drinking heavily increased the risk of these problems.5
6. Investigators studied drinking alcohol and the risk of cardiovascular disease. They looked at large representative samples of the U.S. population. Light and moderate drinking greatly reduced the risk of death from cardiovascular disease.
The investigators analyzed nine surveys conducted by the National Health Interview Survey. It’s an annual survey of U.S. adults. They found that light and moderate drinkers had greatly lower risk of death from cardiovascular disease. That’s when compared with abstainers (including lifetime abstainers) and heavy drinkers. The risk was reduced about 40% among moderate drinkers and almost as much among light drinkers. The pattern of reduction was similar among both sexes and among different age categories.6
Stenting
7. Moderate drinking may help patients recover from coronary stenting. Stenting uses a very small tube to remove blockages from arteries. Drinking alcohol appears to promote healing by reducing inflammation.
Researchers analyzed data on alcohol beverage consumption, an inflammatory protein (CRP), and mortality in 483 subjects who underwent coronary stenting.
By the end of four years, 23% of the patients were readmitted for chest pain, had a heart attack, or died from heart-related causes. Moderate drinking reduced the risk of each of these undesirable outcomes so long as the patient’s CRP level was high enough.
Moderate drinking may promote heart health by reducing inflammation. It also reduces clotting, reduces “bad “cholesterol and increases “good” cholesterol. Additionally, it increases coronary blood flow and reduces blood pressure.7
Reducing Damage
8. Drinking alcohol (beer, wine, or distilled spirits) in moderation reduces the damage to effected tissue following a heart attack. Dr. Ron Korthuis and colleagues reported these findings. This increases heart attack survival.
When a heart attack occurs, blood flow is reduced to several areas of the body. When the blood flow is restored, white blood cells stick to the walls of the arteries. Then they release toxins into the damaged tissues. This causes additional cell death and more damage.
However, alcohol makes the artery walls slick and stops the white blood cells from sticking to the damaged tissue.
Korthuis’ research team compared those who had consumed alcohol before their heart with those who hadn’t. They found that the tissue effected by the low blood flow was much healthier than in those without alcohol.8
9. Doctors studied 353 male heart attack survivors. Men who had two to four drinks after a heart attack are less likely to have a second one. That’s in comparison with abstainers.
Those who had an average of two drinks per day were 59% less likely to have another heart attack. Men who had an average of four drinks per day were 52% less likely, compared to abstainers.9
II. Alcohol, the Heart and Heart Attack Survival
Moderate drinking improves cardiovascular health in many ways. They include these.
- Alcohol improves blood lipid profile by
- Increasing HDL (“good”) cholesterol.
- Decreasing LDL (“bad”) cholesterol.
- Improveing the size of HDL and LDL particles.
- Alcohol decreases thrombosis (blood clotting) by
- Reducing platelet aggregation.
- Reducing fibrinogen (a blood clotter).
- Increasing fibrinolysis. That’s the process of dissolving clots.
- Alcohol also acts through additional ways. These include
- Reducing coronary artery spasm.
- Increasing coronary blood flow.
- Reducing blood pressure.
- Reducing blood insulin level.
- Increasing estrogen levels.
Doctors who reviewed the research concluded that another benefit may be through a AKT/NRF2-dependent mechanism.
Drinking in moderation “increases the involvement of nuclear factor (erythrioid-derived 2)-like (NFE2L2/NRF2) as well as AKT that act as regulators of oxidative balance during oxidative stress responses.”10
The research evidence from around the world demonstrates that drinking alcohol in moderation causes improved health and increased longevity. It also improves heart attack survival.
Of course, anyone who has had a heart attack should discuss the use of alcohol with a doctor.
III. Resources on Heart Attack Survival
Readings
Chilnick, L. The First Year: Heart Disease. NY: Da Capo, 2009.
Greener, M. The Sheldon Short Guide to Heart Attacks. SPCK, 2016.
Turner, G., et al. Recognizing and Surviving Heart Attacks and Strokes. Lifesaving Advice You Need Now. Columbia: U of Missouri Press, 2008.
References for Heart Attack Survival
1. Janszky, I., et al. Alcohol and long-term prognosis after a first acute myocardial infarction. Euro Heart J, 2008, 29(1), 45-53.
2. Gaziano, J., et al. Potential mortality benefits for drinkers with previous heart attacks. Lancet, 1998, 352, M 1882-1885.
3. Pai, J.K., et al. Long-term alcohol consumption in relation to all-cause and cardiovascular mortality among survivors of myocardial infarction. Euro Heart J, 2012; doi:10.1093/eurheartj/ehs047
4. Mukamal, K. Prior alcohol consumption and mortality following acute myocardial infarction. JAMA. 2001 Apr 18;285(15):1965-70.
5. Beulens, J., et al. Alcohol consumption and risk of recurrent cardiovascular events and mortality in patients with clinically manifest vascular disease and diabetes mellitus. Athero, 2010 May 6.
6. Mukamal, K., et al. Alcohol consumption and cardiovascular mortality among U.S. adults, 1987 to 2002. J Am Coll Cardio, 2010, 55, 1328-1335.
7. Zairis, M., et al. C Reactive protein, moderate alcohol consumption, and long term prognosis after successful coronary stenting. Heart, 2004, 90, 419-424.
8. Kamada, K., et al. Antecedent ethanol ingestion prevents postichemic microvascular dysfunction. Pathophys, 2004, 10(2), 131-7.
9. de Lorgeril, M., et al. Wine drinking and risks of cardiovascular complications after recent acute myocardial infarction. Circ, 2002, 106, 1465-1469.
10. Walker, R., et al. The good, the bad, and the ugly with alcohol use on the heart. Alco Clin Exper Res, 2013 Mar 25. doi: 10.1111/acer.12109.