Alcohol and cardiovascular disease: Difference between revisions
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{{also|Alcoholic cardiomyopathy}} |
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{{Short description|Effects of alcohol consumption on cardiovascular health}} |
{{Short description|Effects of alcohol consumption on cardiovascular health}} |
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[[File:Alcohol by Country.png|thumb|200px|Total recorded alcohol per capita consumption, in litres of pure alcohol |
[[File:Alcohol by Country.png|thumb|200px|Total recorded alcohol per capita consumption, in litres of pure alcohol<ref>{{cite book |author =World Health Organization |title=Global Status Report on Alcohol 2004 |location=Geneva |year=2004 |isbn=978-92-4-156272-0 |url=https://www.who.int/substance_abuse/publications/global_status_report_2004_overview.pdf}}</ref>]] |
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{{In use}} |
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| ⚫ | Excessive [[Alcohol (drug)|alcohol]] intake is associated with an elevated risk of [[alcoholic liver disease]] (ALD), [[heart failure]], some [[Alcohol and cancer|cancer]]s, and accidental injury, and is a leading cause of preventable death in industrialized countries.<ref name="pmid15385917">{{cite journal | author = Centers for Disease Control and Prevention (CDC) | title = Alcohol-attributable deaths and years of potential life lost--United States, 2001 |journal = MMWR. Morbidity and Mortality Weekly Report |volume = 53 |issue = 37 |pages = 866–870 |date = 2004 | pmid = 15385917 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5337a2.htm }}</ref> Some studies have suggested that one drink per day may have cardiovascular benefits. However, |
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In a 2018 study on 599,912 drinkers, a roughly linear association was found with alcohol consumption and a higher risk of [[stroke]], [[coronary artery disease]] excluding [[myocardial infarction]], [[heart failure]], fatal [[Hypertension|hypertensive disease]], and fatal [[aortic aneurysm]], even for moderate drinkers.<ref>{{cite journal |vauthors=Wood AM, Kaptoge S, Butterworth AS, Willeit P, Warnakula S, Bolton T, et al.|title=Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. |journal=The Lancet |volume=391 |issue=10129 |pages=1513–1523 |date=2018 |pmid= 29676281|doi=10.1016/S0140-6736(18)30134-X |pmc=5899998 }}</ref>{{Primary source inline|date=March 2021}} The [[American Heart Association]] states that people who are currently non-drinkers should not start drinking alcohol.<ref>{{cite web |url=https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/alcohol-and-heart-health |title=Alcohol and Heart Health |publisher=American Heart Association |date=August 15, 2014 }}</ref> |
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== Evidence for alcohol cardioprotection == |
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| ⚫ | Some early reviews showed that light alcohol consumption may have a protective effect on cardiovascular health. For instance, a meta-analysis from 2010 found that patients with cardiovascular disease who were light to moderate alcohol consumers, were less likely to suffer from cardiovascular and all-cause mortality.<ref name=":0" /> However, the researchers warned against encouraging cardiovascular patients who do not regularly consume alcohol to start drinking due to lack of controlled intervention studies and evidence.<ref name=":0">{{cite journal |last1=Costanzo |first1=S |last2=Di Castelnuovo |first2=A |last3=Donati |first3=MB |last4=Iacoviello |first4=L |last5=de Gaetano |first5=G |date=2010 |title=Alcohol consumption and mortality in patients with cardiovascular disease: a meta-analysis. |journal=Journal of the American College of Cardiology |volume=55 |issue=13 |pages=1339–1347 |doi=10.1016/j.jacc.2010.01.006 |pmid=20338495 |doi-access= |
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| ⚫ | Excessive [[Alcohol (drug)|alcohol]] intake is associated with an elevated risk of [[alcoholic liver disease]] (ALD), [[heart failure]], some [[Alcohol and cancer|cancer]]s, and accidental injury, and is a leading cause of preventable death in industrialized countries.<ref name="pmid15385917">{{cite journal | author = Centers for Disease Control and Prevention (CDC) | title = Alcohol-attributable deaths and years of potential life lost--United States, 2001 |journal = MMWR. Morbidity and Mortality Weekly Report |volume = 53 |issue = 37 |pages = 866–870 |date = 2004 | pmid = 15385917 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5337a2.htm }}</ref> Some studies have suggested that one drink per day may have cardiovascular benefits. However, these studies are controversial,<ref name=":1">{{Cite web |last=American Heart Association |date=2020 |title=Is drinking alcohol part of a healthy lifestyle? |url=https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/alcohol-and-heart-health |website=American Heart Association}}</ref> and the common view is that no level of alcohol consumption improves health.<ref>{{Cite journal |last1=Burton |first1=Robyn |last2=Sheron |first2=Nick |date=September 2018 |title=No level of alcohol consumption improves health |journal=The Lancet |language=en |volume=392 |issue=10152 |pages=987–988 |doi=10.1016/S0140-6736(18)31571-X|pmid=30146328 |s2cid=52075453 |doi-access=free }}</ref> There is far more evidence for the harmful effects of alcohol than for any beneficial effects.<ref>{{Cite journal |last=Fekjær |first=Hans Olav |date=December 2013 |title=Alcohol—a universal preventive agent? A critical analysis |journal=Addiction |language=en |volume=108 |issue=12 |pages=2051–2057 |doi=10.1111/add.12104 |pmid=23297738 |issn=0965-2140|doi-access=free }}</ref> It is also recognized that the alcohol industry may promote the unsubstantiated benefits of moderate drinking.<ref>{{Cite journal |last=Casswell |first=Sally |date=April 2013 |title=Vested interests in addiction research and policy. Why do we not see the corporate interests of the alcohol industry as clearly as we see those of the tobacco industry?: Alcohol corporate interests compared with tobacco |url=https://onlinelibrary.wiley.com/doi/10.1111/add.12011 |journal=Addiction |language=en |volume=108 |issue=4 |pages=680–685 |doi=10.1111/add.12011|pmid=23496067 }}</ref> |
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There is a lack of medical consensus about whether moderate consumption of beer, wine, or distilled spirits has a stronger association with heart disease. Studies suggest that each is effective, with none having a clear advantage. Most researchers now believe that the most important ingredient is the alcohol itself.<ref name="Rimm96">{{cite journal |vauthors=Rimm EB, Klatsky A, Grobbee D, Stampfer MJ |date=March 1996 |title=Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits |journal=BMJ |volume=312 |issue=7033 |pages=731–6 |doi=10.1136/bmj.312.7033.731 |pmc=2350477 |pmid=8605457}}</ref><ref>{{cite journal |vauthors=Barefoot JC, Grønbaek M, Feaganes JR, McPherson RS, Williams RB, Siegler IC |date=August 2002 |title=Alcoholic beverage preference, diet, and health habits in the UNC Alumni Heart Study |journal=The American Journal of Clinical Nutrition |volume=76 |issue=2 |pages=466–72 |doi=10.1093/ajcn/76.2.466 |pmid=12145024 |doi-access=free}}</ref> |
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== Alcohol intake and cardiovascular disease == |
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| ⚫ | The American Heart Association states that drinking too much alcohol increases health risks including |
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| ⚫ | Some early reviews showed that light alcohol consumption may have a protective effect on cardiovascular health. For instance, a meta-analysis from 2010 found that patients with cardiovascular disease who were light to moderate alcohol consumers, were less likely to suffer from cardiovascular and all-cause mortality.<ref name=":0" /> However, the researchers warned against encouraging cardiovascular patients who do not regularly consume alcohol to start drinking due to lack of controlled intervention studies and evidence.<ref name=":0">{{cite journal |last1=Costanzo |first1=S |last2=Di Castelnuovo |first2=A |last3=Donati |first3=MB |last4=Iacoviello |first4=L |last5=de Gaetano |first5=G |date=2010 |title=Alcohol consumption and mortality in patients with cardiovascular disease: a meta-analysis. |journal=Journal of the American College of Cardiology |volume=55 |issue=13 |pages=1339–1347 |doi=10.1016/j.jacc.2010.01.006 |pmid=20338495 |doi-access=}}</ref> |
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| ⚫ | Several possible mechanisms have been suggested for the cardioprotective effect of alcohol. These include glucose control, lipid metabolism, and metabolism as a whole.<ref>{{cite journal |last1=Fragopoulou |first1=E |last2=Choleva |first2=M |last3=Antonopoulou |first3=S |last4=Demopoulos |first4=CA |date=2018 |title=Wine and its metabolic effects. A comprehensive review of clinical trials. |journal=Metabolism: Clinical and Experimental |volume=83 |pages=102–119 |doi=10.1016/j.metabol.2018.01.024 |pmid=29408458 |s2cid=29149518}}</ref> However, another possible explanation is that the cardioprotective effect is only a confounding research result.<ref>{{Cite journal |last1=Roerecke |first1=Michael |last2=Rehm |first2=Jürgen |date=2014-10-21 |title=Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers |journal=BMC Medicine |volume=12 |issue=1 |page=182 |doi=10.1186/s12916-014-0182-6 |pmid=25567363 |pmc=4203905 |issn=1741-7015 |doi-access=free }}</ref> A logical possibility is that some of the alcohol [[abstainer]]s in research studies previously drank excessively and had undermined their health. After they quit they were categorized as non-drinkers, which in turn lead to more sick people in the non-drinkers category. To test this hypothesis, a 2019 meta analysis has recategorized people accordingly. As a result, no benefit was found for alcohol consumption of any dosage, moreover, alcohol was detrimental to health even at low doses.<ref>{{Cite journal |last1=Stockwell |first1=Tim |last2=Zhao |first2=Jinhui |last3=Panwar |first3=Sapna |last4=Roemer |first4=Audra |last5=Naimi |first5=Timothy |last6=Chikritzhs |first6=Tanya |date=March 2016 |title=Do "Moderate" Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality |journal=Journal of Studies on Alcohol and Drugs |volume=77 |issue=2 |pages=185–198 |doi=10.15288/jsad.2016.77.185 |issn=1938-4114 |pmc=4803651 |pmid=26997174}}</ref> |
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Heart disease is the largest cause of mortality in the United States and many other countries. Therefore, some physicians have suggested that patients be informed of the potential health benefits of drinking alcohol in moderation, especially if they abstain and alcohol is not [[contraindication|contraindicated]]. Others, however, argue against the practice in fear that it might lead to heavy or abusive alcohol consumption. Heavy drinking is associated with a number of health and safety problems.{{citation needed|date=November 2021}} |
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| ⚫ | The American Heart Association states that drinking too much alcohol increases health risks including cardiovascular disease precursors such as obesity, high blood pressure, high triglycerides and also heart attacks and strokes. They warn that "We’ve all seen the headlines about studies associating light or moderate drinking with health benefits and reduced mortality. Some researchers have suggested there are health benefits from wine, especially red wine, and that a glass a day can be good for the heart. But there’s more to the story. No research has proved a cause-and-effect link between drinking alcohol and better heart health.."<ref name=":1" /> |
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| ⚫ | A logical possibility is that some of the alcohol [[abstainer]]s in research studies previously drank excessively and had undermined their health. After they quit they were categorized as non-drinkers, which in turn lead to more sick people in the non-drinkers category. To test this hypothesis, a meta analysis has recategorized people accordingly. As a result, |
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Several possible mechanisms have been suggested for the cardioprotective effect of alcohol. These include glucose control, lipid metabolism, and metabolism as a whole. <ref>{{cite journal |last1=Fragopoulou |first1=E |last2=Choleva |first2=M |last3=Antonopoulou |first3=S |last4=Demopoulos |first4=CA |date=2018 |title=Wine and its metabolic effects. A comprehensive review of clinical trials. |journal=Metabolism: Clinical and Experimental |volume=83 |pages=102–119 |doi=10.1016/j.metabol.2018.01.024 |pmid=29408458 |s2cid=29149518}}</ref> |
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== Alcohol reduction == |
== Alcohol reduction == |
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:III. For people who consumed 6 or more drinks per day, reduction rate on blood pressure was the strongest when they reduced alcohol consumption close to abstinence. |
:III. For people who consumed 6 or more drinks per day, reduction rate on blood pressure was the strongest when they reduced alcohol consumption close to abstinence. |
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:IV. The effect of alcohol reduction on blood pressure is still unclear for women and hypertensive patients who consume less than three drinks per day due to limited clinical trials. |
:IV. The effect of alcohol reduction on blood pressure is still unclear for women and hypertensive patients who consume less than three drinks per day due to limited clinical trials. |
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==History== |
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In 2010, a systematic review reported that moderate consumption of alcohol does not cause harm to people with cardiovascular disease. However, the authors did not encourage people to start drinking alcohol in the hope of any benefit.<ref>{{cite journal |vauthors=Costanzo S, Di Castelnuovo A, Donati MB, Iacoviello L, de Gaetano G |title=Alcohol consumption and mortality in patients with cardiovascular disease: a meta-analysis |journal=J. Am. Coll. Cardiol. |volume=55 |issue=13 |pages=1339–1347 |date=2010 |pmid=20338495 |doi=10.1016/j.jacc.2010.01.006 }}</ref> |
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== See == |
== See == |
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* [[ |
* [[French paradox]] |
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* [[Long-term effects of alcohol consumption]] |
* [[Long-term effects of alcohol consumption]] |
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== References == |
== References == |
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{{reflist|2}} |
{{reflist|2}} |
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== Further reading == |
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{{refbegin}} |
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* {{cite journal | vauthors = Tolstrup J, Jensen MK, Tjønneland A, Overvad K, Mukamal KJ, Grønbaek M | title = Prospective study of alcohol drinking patterns and coronary heart disease in women and men | journal = BMJ | volume = 332 | issue = 7552 | pages = 1244–1248 | date =2006 | pmid = 16672312 | pmc = 1471902 | doi = 10.1136/bmj.38831.503113.7C }} |
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* {{cite journal | vauthors = O'Keefe JH, Bhatti SK, Bajwa A, DiNicolantonio JJ, Lavie CJ | title = Alcohol and cardiovascular health: the dose makes the poison…or the remedy | journal = Mayo Clinic Proceedings | volume = 89 | issue = 3 | pages = 382–393 | date =2014 | pmid = 24582196 | doi = 10.1016/j.mayocp.2013.11.005 | doi-access = free }} |
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{{refend}} |
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== External links == |
== External links == |
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* [https://web.archive.org/web/20070701174135/http://www.health.gov/DIETARYGUIDELINES/dga2005/document/html/chapter9.htm USDA Dietary Guidelines for Americans 2005: Chapter 9 Alcoholic Beverages] |
* [https://web.archive.org/web/20070701174135/http://www.health.gov/DIETARYGUIDELINES/dga2005/document/html/chapter9.htm USDA Dietary Guidelines for Americans 2005: Chapter 9 Alcoholic Beverages] |
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* [https://www.hopkinsmedicine.org/health/wellness-and-prevention/alcohol-and-heart-health-separating-fact-from-fiction Alcohol and heart health: Separating fact from fiction], [[Johns Hopkins School of Medicine|Johns Hopkins Medicine]] |
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{{alcohealth}} |
{{alcohealth}} |
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{{DEFAULTSORT:Alcohol And Cardiovascular Disease}} |
{{DEFAULTSORT:Alcohol And Cardiovascular Disease}} |
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[[Category:Cardiovascular diseases]] |
[[Category:Cardiovascular diseases]] |
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[[Category:Health effects of alcohol]] |
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Revision as of 03:20, 16 May 2024
In a 2018 study on 599,912 drinkers, a roughly linear association was found with alcohol consumption and a higher risk of stroke, coronary artery disease excluding myocardial infarction, heart failure, fatal hypertensive disease, and fatal aortic aneurysm, even for moderate drinkers.[2][non-primary source needed] The American Heart Association states that people who are currently non-drinkers should not start drinking alcohol.[3]
Excessive alcohol intake is associated with an elevated risk of alcoholic liver disease (ALD), heart failure, some cancers, and accidental injury, and is a leading cause of preventable death in industrialized countries.[4] Some studies have suggested that one drink per day may have cardiovascular benefits. However, these studies are controversial,[5] and the common view is that no level of alcohol consumption improves health.[6] There is far more evidence for the harmful effects of alcohol than for any beneficial effects.[7] It is also recognized that the alcohol industry may promote the unsubstantiated benefits of moderate drinking.[8]
Alcohol intake and cardiovascular disease
Some early reviews showed that light alcohol consumption may have a protective effect on cardiovascular health. For instance, a meta-analysis from 2010 found that patients with cardiovascular disease who were light to moderate alcohol consumers, were less likely to suffer from cardiovascular and all-cause mortality.[9] However, the researchers warned against encouraging cardiovascular patients who do not regularly consume alcohol to start drinking due to lack of controlled intervention studies and evidence.[9]
Several possible mechanisms have been suggested for the cardioprotective effect of alcohol. These include glucose control, lipid metabolism, and metabolism as a whole.[10] However, another possible explanation is that the cardioprotective effect is only a confounding research result.[11] A logical possibility is that some of the alcohol abstainers in research studies previously drank excessively and had undermined their health. After they quit they were categorized as non-drinkers, which in turn lead to more sick people in the non-drinkers category. To test this hypothesis, a 2019 meta analysis has recategorized people accordingly. As a result, no benefit was found for alcohol consumption of any dosage, moreover, alcohol was detrimental to health even at low doses.[12]
The American Heart Association states that drinking too much alcohol increases health risks including cardiovascular disease precursors such as obesity, high blood pressure, high triglycerides and also heart attacks and strokes. They warn that "We’ve all seen the headlines about studies associating light or moderate drinking with health benefits and reduced mortality. Some researchers have suggested there are health benefits from wine, especially red wine, and that a glass a day can be good for the heart. But there’s more to the story. No research has proved a cause-and-effect link between drinking alcohol and better heart health.."[5]
Alcohol reduction
It is well known that alcohol consumption increases the risk of hypertension. Hence, many clinical trials examined the effect of reduction in alcohol consumption on blood pressure. Systematic review and meta-analysis have shown that effect of alcohol reduction on blood pressure is dose dependent.[13]
- I. For people who consumed 2 or fewer drinks per day, blood pressure was not significantly decreased when they reduced alcohol consumption close to abstinence.
- II. For people who consumed 3 or more drinks per day, blood pressure was significantly decreased when they reduced alcohol consumption close to abstinence.
- III. For people who consumed 6 or more drinks per day, reduction rate on blood pressure was the strongest when they reduced alcohol consumption close to abstinence.
- IV. The effect of alcohol reduction on blood pressure is still unclear for women and hypertensive patients who consume less than three drinks per day due to limited clinical trials.
History
In 2010, a systematic review reported that moderate consumption of alcohol does not cause harm to people with cardiovascular disease. However, the authors did not encourage people to start drinking alcohol in the hope of any benefit.[14]
See
References
- ^ World Health Organization (2004). Global Status Report on Alcohol 2004 (PDF). Geneva. ISBN 978-92-4-156272-0.
{{cite book}}: CS1 maint: location missing publisher (link) - ^ Wood AM, Kaptoge S, Butterworth AS, Willeit P, Warnakula S, Bolton T, et al. (2018). "Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies". The Lancet. 391 (10129): 1513–1523. doi:10.1016/S0140-6736(18)30134-X. PMC 5899998. PMID 29676281.
- ^ "Alcohol and Heart Health". American Heart Association. August 15, 2014.
- ^ Centers for Disease Control and Prevention (CDC) (2004). "Alcohol-attributable deaths and years of potential life lost--United States, 2001". MMWR. Morbidity and Mortality Weekly Report. 53 (37): 866–870. PMID 15385917.
- ^ a b American Heart Association (2020). "Is drinking alcohol part of a healthy lifestyle?". American Heart Association.
- ^ Burton, Robyn; Sheron, Nick (September 2018). "No level of alcohol consumption improves health". The Lancet. 392 (10152): 987–988. doi:10.1016/S0140-6736(18)31571-X. PMID 30146328. S2CID 52075453.
- ^ Fekjær, Hans Olav (December 2013). "Alcohol—a universal preventive agent? A critical analysis". Addiction. 108 (12): 2051–2057. doi:10.1111/add.12104. ISSN 0965-2140. PMID 23297738.
- ^ Casswell, Sally (April 2013). "Vested interests in addiction research and policy. Why do we not see the corporate interests of the alcohol industry as clearly as we see those of the tobacco industry?: Alcohol corporate interests compared with tobacco". Addiction. 108 (4): 680–685. doi:10.1111/add.12011. PMID 23496067.
- ^ a b Costanzo, S; Di Castelnuovo, A; Donati, MB; Iacoviello, L; de Gaetano, G (2010). "Alcohol consumption and mortality in patients with cardiovascular disease: a meta-analysis". Journal of the American College of Cardiology. 55 (13): 1339–1347. doi:10.1016/j.jacc.2010.01.006. PMID 20338495.
- ^ Fragopoulou, E; Choleva, M; Antonopoulou, S; Demopoulos, CA (2018). "Wine and its metabolic effects. A comprehensive review of clinical trials". Metabolism: Clinical and Experimental. 83: 102–119. doi:10.1016/j.metabol.2018.01.024. PMID 29408458. S2CID 29149518.
- ^ Roerecke, Michael; Rehm, Jürgen (2014-10-21). "Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers". BMC Medicine. 12 (1): 182. doi:10.1186/s12916-014-0182-6. ISSN 1741-7015. PMC 4203905. PMID 25567363.
- ^ Stockwell, Tim; Zhao, Jinhui; Panwar, Sapna; Roemer, Audra; Naimi, Timothy; Chikritzhs, Tanya (March 2016). "Do "Moderate" Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality". Journal of Studies on Alcohol and Drugs. 77 (2): 185–198. doi:10.15288/jsad.2016.77.185. ISSN 1938-4114. PMC 4803651. PMID 26997174.
- ^ Roerecke, M; Kaczorowski, J; Tobe, SW; Gmel, G; Hasan, OSM; Rehm, J (2017). "The effect of a reduction in alcohol consumption on blood pressure: a systematic review and meta-analysis". The Lancet. Public Health. 2 (2): e108–e120. doi:10.1016/S2468-2667(17)30003-8. PMC 6118407. PMID 29253389.
- ^ Costanzo S, Di Castelnuovo A, Donati MB, Iacoviello L, de Gaetano G (2010). "Alcohol consumption and mortality in patients with cardiovascular disease: a meta-analysis". J. Am. Coll. Cardiol. 55 (13): 1339–1347. doi:10.1016/j.jacc.2010.01.006. PMID 20338495.
External links
- USDA Dietary Guidelines for Americans 2005: Chapter 9 Alcoholic Beverages
- Alcohol and heart health: Separating fact from fiction, Johns Hopkins Medicine
