The Link Between Drinking Alcohol and Heart Disease?

The associations between drinking and CV diseases such as hypertension, coronary heart disease, stroke, peripheral arterial disease, and cardiomyopathy have been studied extensively and are outlined in this review. Although many behavioral, genetic, and biologic variants influence the interconnection between alcohol use and CV disease, dose and pattern of alcohol consumption seem to modulate this most. Low-to-moderate alcohol use may mitigate certain mechanisms such as risk and hemostatic factors affecting atherosclerosis and inflammation, pathophysiologic processes integral to most CV disease. Both the negative and positive effects of alcohol use on particular CV conditions are presented here.

It also notes that excessive alcohol intake could also increase the risk of coronary artery disease (CAD) and heart attack. In a meta-analysis of 11 cohorts published in 2014, an inverse risk relationship between average alcohol consumption and IHD in patients with hypertension was reported 37. Similar associations have been reported among people with diabetes and non-fatal myocardial infarction 38,39,40,41,42. A recent large-scale study from the UK reported a J-curve for most CVD outcomes in patients with CVD 43.

“The stress level of someone in the midst of a cancer workup is likely quite high and may not reflect the typical stress level of an average person,” he notes. Some of the potential cellular changes related to ethanol consumption reviewed above are illustrated in figure 5. More than one cellular event may be happening at the same time, and, as with other chronic health conditions, the relevant mechanisms may be synergistic and interrelated. On average, a regular heart rate is about 60 to 100 beats per minute when your body is at rest. But alcohol can lead to your heart rate temporarily jumping up in speed, and if it goes over 100 beats per minute, it can cause a condition called tachycardia.

However, to date there have been few intervention studies conducted to experimentally examine the effects of regular alcohol intake on weight gain or obesity in humans. All of the available studies have examined moderate intake of alcohol, and the majority have reported results on beer and wine intake, but not other forms of alcohol 3•, 5. Crouse and Grundy 48 looked at the effect of adding 630 kcal/day of alcohol to the diets of 12 men in a metabolic unit. There were no significant changes in weight for normal weight participants over the four-week intervention study. They however noted that about half of the obese participants gained weight, with the largest weight gain being 1.8 kg 48. In a randomized crossover study, Cordain et al. 49 found that drinking two glasses of red wine (270 mL) with dinner daily for six weeks did not lead to changes in weight or body fat percentage in 14 men.

Want to get fit and healthy?

1. Sierksma et al.131 identified a U-shaped relationship between alcohol consumption and the aortic pulse wave velocity.
2. They also had lower levels of circulating inflammatory markers, such as C-terminal proendothelin-1 and pentraxin-3 (Cosmi et al. 2015).
3. Data from transgenic animal models and pharmacologic approaches strongly support a role for ethanol-induced oxidative stress in CV disease.
4. The Dietary Guidelines for Americans recommends that adults of legal drinking age try to avoid drinking alcohol if possible.

In humans, endothelial function is assessed by measuring the widening (i.e., dilation) of the brachial artery under different conditions. Some research noted that endothelial function is impaired in abstinent individuals with a long-term history of alcohol abuse or alcoholism (Di Gennaro et al. 2007, 2012; Maiorano et al. 1999). Other studies have examined the effect of a single binge-drinking episode and found impairment in brachial artery endothelial-dependent and -independent vasodilation (Bau et al. 2005; Hashimoto et al. 2001; Hijmering et al. 2007). Therefore, as in animal studies, the effects of ethanol on endothelial function in humans likely depend on the dose and duration of ethanol consumption.

Alcohol and Heart Disease

One approach included overexpression of proteins such as insulin-like growth factor (IGF-1), which stimulates growth and cell proliferation and has antiapoptotic effects (see Zhang et al. 2014). In contrast to control mice, the IGF-1−expressing animals exhibited no evidence of changes in expression of antioxidant enzymes (i.e., superoxide dismutase-1) or any decreases in contractile function after 16 weeks of ethanol consumption. The findings suggest a protective effect of overexpression of IGF-1 in the transgenic animals (Zhang et al. 2014). The relationship between alcohol consumption and total cerebrovascular disease is generally J-shaped, although it differs according to subtypes of stroke 105, 116 (Figure 5). A positive linear relationship has been observed between the level of alcohol consumption and risk of brain or subarachnoid hemorrhage.8, 110, 116, 117 Actions on the BP and blood coagulation system seem to be underlying mechanisms for this adverse influence of alcohol. These recommendations put forward by the guidelines are appropriate because small doses of alcohol exert little adverse effects on BP and the cardiovascular system.

I have a heart condition. Should I give up alcohol?

Puddey et al.83 reported a BP elevation of ∼10 mm Hg and decreases in the level of phospholipids and the ratio of unsaturated/saturated fatty acids in the aorta and kidney after the chronic administration of alcohol to rats. Harada et al.84 also observed increases hope house boston in the BP and platelet-free calcium concentration with ethanol consumption (15%) in Wister Kyoto rats. Most clinical studies have not considered the timing of alcohol intake and BP measurement. We studied the effect of repeated episodes of alcohol consumption on BP with ABPM under standardized conditions in Japanese men with hypertension.73 After several days of the control period, the subjects consumed 1 ml kg−1 of alcohol with an evening meal for 7 days. Evening BP values decreased for several hours after alcohol consumption on both days 1 and 7, whereas morning BP was unchanged on day 1 but increased on day 7. The average 24-h BP was lower on day 1 and was the same on day 7 compared with the control period.

The combination of impairment of the baroreceptor reflex and systemic vasodilation acts to potentiate orthostatic hypotension and may induce syncope after drinking in susceptible subjects. The effect of a single intake of alcohol on BP in normal subjects is not consistent among studies. Some studies have shown an increase in BP,13, 14 whereas it decreased15, 16 or remained unchanged17, 18 in others.

So even if you don’t have any alcohol during the week, you shouldn’t save all of your drinking for the weekend and overdo it. It may be that people who enjoy theoccasional glass of red are more likely to follow a heart-healthy diet, such asthe Mediterranean-style diet. If you enjoy red wine and you’re healthy, it’sprobably fine to enjoy it in moderation. You eat well, exercise and try to stay healthy— but you also enjoy a beer while watching the game, or a glass of wine atdinner. The lack of consistent data means that the takeaway message here is moderation — and the importance of avoiding excessive and binge drinking.

Van den Elzen et al.132 observed an inverse relationship between the alcohol intake and pulse wave velocity in young men and women. On the other hand, Kurihara et al.133 reported that the brachial–ankle pulse wave velocity was elevated in heavy drinkers. These studies also support the favorable effect of moderate and the harmful effect of heavy drinking on large arteries.

For many people this is clearly not the case, and even lifetime abstainers are hard to identify 82. Finally, in studies of people from certain Eastern European countries, investigators have failed to find a cardioprotective effect with any level of ethanol consumption (Britton and McKee 2000). This suggests that alcoholic beverage type may be an important mediator, because in countries such as Russia, spirits are the alcoholic beverage of choice. However, the negative associations between alcohol consumption and CV outcomes in these countries also may relate to pervasive patterns of binge drinking (Leon et al. 2009). Thus, low levels of alcohol consumption (1 to 2 drinks, but not every day) in patients with heart failure may not exacerbate the condition, especially in those with heart failure attributable to ischemic CHD.