Heart Health

Alcohol and Heart Disease

Are there safe levels of alcohol consumptions for heart patients?

In August, a study published in The Lancet, suggested there is no safe level of alcohol as beneficial effects against ischemic heart disease. Researchers stated, “Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions.” One of the most common questions heart patients are asked by their doctor is, “How much alcohol do you consume?Dr. Robert Benton, Chief of Cardiology at Samaritan Hospital and Director of the Capital Cardiology Associates, Division of Clinical Research stated, “The alcohol question is always in the initial history of a patient. I often counsel a patient on what’s appropriate for their disease or condition. We have to look at everything, blood pressure, pulse, not having arrhythmia… it’s a big story to put together.”

After a heart attack, cardiac event, or diagnosis of heart disease, heart patients can sometimes be overwhelmed with a list of new rules they must live by. There are new medications to take, lifestyle changes like dieting or exercise, along with doctors appointments and other tests/checkups to schedule. As part of returning to a new normal life, patients will often ask their doctor when and if it’s safe to drink alcohol. Every year, there can be conflicting research on the benefits and risks of alcohol and heart disease. “This paper was in The Lancet and offered a retrospective look at countries around the world to see if there were any safe levels of alcohol,” said Dr. Benton.

Wine being poured into a glass

Dr. Benton summarized The Lancet article as a comprehensive, detailed analysis of “safe levels” in retrospective trials. “This study looked worldwide at the huge health burden related to alcohol use even at very low levels which would be less than one drink a day,” he said. The definition for “one drink” is one five ounce glass of wine, 12 ounces of beer (which in the US has 5% alcohol), and or one and a half ounces of 80 proof alcohol or just one shot. “The upside is that if you looked at the study in totality, you would find cancer, self-harm, and tuberculosis, as the three areas of increased events of the middle age range. Within that, there are going to be people, I would adhere to this opinion myself, who are moderate alcohol drinkers using the definitions I just gave you, who have some health benefits to drinking moderate amounts of alcohol.”

“Let me be clear on this point,” began Dr. Benton. “I would never tell or suggest to anyone to start drinking alcohol for any perceived health benefits.” But the discussion comes up frequently. “I usually have it with people who are new to me, new for primary prevention, or a patient in the hospital after having a cardiac event like a heart attack or stroke or surgery,” he said. “I often counsel a patient on what’s appropriate for their disease or condition.”

Alcohol in moderation

“I think for people who safely consume moderate levels (as outlined) there are some benefits to mildly lowering blood pressure, cholesterol, and preventing ischemic stroke (a dry stroke),” shared Dr. Benton. The Lancet study (funded by the Bill and Melinda Gates Foundation) was not the first to explore alcohol’s complex association with health. The authors of this study estimate that, for one year, in people aged 15-95 years, drinking one alcoholic drink a day increases the risk of developing one of the 23 alcohol-related health problems by 0.5%, compared with not drinking at all. So far, the strongest evidence with heart health has shown that alcohol can increase levels of HDL (good) cholesterol. The Mediterranean Diet (endorsed by the Mayo Clinic)  says one standard 5 oz. glass of red wine at dinner is okay. 

Here are some findings from other studies:
• Agavins, the natural sugar in tequila, is shown to help lower cholesterol and can help you lose weight.
• The active compounds in red wine (polyphenols, resveratrol, and quercetin) have been proven to improve overall heart health.
• Whiskey also contains ellagic acid, which known for fighting off cancer by absorbing rogue cells.
• The polyphenols in rosé have been shown to prevent atherosclerosis, a major contributor to heart disease.

Couple on wine tasting tour

The health risks of drinking alcohol vary widely from person to person

“But as you know we have a lot of problems with the downside and damage caused by overconsumption,” cautioned Dr. Benton. “Too much alcohol can also raise your blood pressure, leading to hemorrhagic stroke, referred to as a bleeding stroke in your brain. Alcohol also has toxicity on the electoral system in your heart which can lead to atrial fibrillation. I certainly have a stable full of people with cardiomyopathy and A-fib related to alcohol and they are still drinking. That is not good. That is the opposite conversation!” Dr. Benton points out that even healthy people can have problems processing alcohol which is why the American Heart Association recommends no more than one drink per day for women and two for men. “There is evidence that heavy alcohol use can cause cardiomyopathy (weakened heart). Even healthy people can develop A-fib or as we call it “holiday heart”, we see that in young people who binge drink at parties or are over served,” he said.

But in terms of moderate alcohol use, for a person who has been drinking, had an event or is being treated for primary prevention, “My own opinion, and I think you’d find the opinion would be pretty solid amongst most cardiologists, that person is safe,” shared Dr. Benton. “That doesn’t mean I’m talking to everybody but I’m talking to probably, most people.” Most importantly, Dr. Benton urges people to talk with their doctor or health care provider. “This whole alcohol issue has many different sides to it.” At best he says, “This is a personal decision, advice is individualized for each patient.”

Written by: Michael Arce, Media Specialist
Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.