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How Does Alcohol Affect the Heart?

Alcohol Affects Liver

While alcohol’s harmful effects on the liver are well known, rarely is alcohol’s impact on the cardiovascular system discussed. Luckily unlike alcohol and the liver there is some good news here… while sustained heavy drinking will have a negative impact on the heart, moderate drinking can actually be beneficial!

Cardiovascular Benefits of Moderate Drinking

While alcohol’s harmful health effects have long been known, the investigation into its potentially beneficial effects didn’t begin in earnest until 1904, when it was noticed that despite a diet high in saturated fats the French had an overall lower risk of cardiovascular disease. Labelled the French Paradox, some suggested this statistical anomaly was due to the higher consumption of red wine in France.

Since then, research has shown the link between reduced risk of heart disease and moderate alcohol consumption to be well established. [1] The research has repeatedly shown that low levels of alcohol intake (1-2 drinks per day for women, 2-4 drinks per day for men) is not only associated with lower incidence of cardiovascular disease, but also lower risks of total mortality when compared with non-drinkers by 17% in men and 18% in women. [1] This effect presents itself in a J-shaped relationship, and the mortality risk increases over that of non-drinkers and moderate drinkers when daily alcohol intake exceeds 2 drinks per day for women or 4 for men. [1]

After this research was first presented, some have suggested that confounding variables were influencing the results. For example, perhaps moderate drinkers are more likely to have healthier lifestyles in general or have a higher socioeconomic status and this access to better healthcare. Later studies have corrected for these possible confounding variables and found that the decreased risk of heart disease really was due to moderate alcohol consumption. [2] One 2006 study found that even in men already at low risk of heart disease due to their healthy diets and lifestyles, that moderate alcohol intake is associated with lower risk of heart attacks. [3] Providing even more evidence was a later study that found when men who consumed very low amounts of alcohol increased their alcohol use to moderate levels they significantly reduced their risk of coronary heart disease. [4]

Yet another study on people at risk for developing heart disease found that adopting a Mediterranean diet, which encourages daily wine consumption, reduced cardiovascular problems by about 30%. [5] The effect was so significant the study was halted prematurely.

Another theory put forward on why moderate drinkers have a lower risk was that some of the abstainers included in past studies may have previously drank excessively and had already damaged their health. This hypothesis was also found incorrect, as future studies on subjects who had never consumed alcohol before in their lives found the same beneficial effects from moderate drinking. [6]

Scientists have even identified a possible mechanism for these beneficial effects. Regular alcohol consumption in moderation decreases levels of fibrinogen, a protein that causes clot formation. It also increases levels of tissue type plasminogen activator, which is an enzyme that dissolves blood clots.

As seen by the above evidence, at this point the beneficial effects of moderate alcohol consumption have been well established. Also well established, however, are the harmful effects of heavy drinking.

Heavy Drinking and Increased Risk of Cardiovascular Disease

While moderate daily alcohol use is beneficial, these positive effects quickly reverse when use becomes heavier. High levels of alcohol consumption are associated with increased risks of liver disease, cancer, pancreatitis, malnutrition, and damage to the central and peripheral nervous systems, among many others. In fact, long-term use of alcohol at high levels can damage nearly every organ and system in the body, and the cardiovascular system is no exemption. [7]

Long-term use of high dose alcohol can lead to a condition called alcoholic cardiomyopathy, which is caused by direct toxic effects of alcohol on heart muscle tissue. Eventually this damage impairs the ability of the heart to efficiently pump blood, leading to heart failure. Excessive alcohol consumption also causes an increased risk of stroke, hypertension, and hypertriglyceridemia. [8]

Cited Sources

  1. Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies.
  2. Alcohol and heart disease
  3. Alcohol consumption and risk for coronary heart disease in men with healthy lifestyles.
  4. Seven-year changes in alcohol consumption and subsequent risk of cardiovascular disease in men.
  5. Primary Prevention of Cardiovascular disease with a Mediterranean diet.
  6. Moderate alcohol use and reduced mortality risk: Systematic error in prospective studies.
  7. Drinks, Drugs, and Dependence: From Science to Clinical Practice.
  8. The cardiovascular implications of alcohol and red wine

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