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Encyclopedia > Alcohol and heart attacks

The subject of alcohol and heart attacks is important because the major cause of death in the United States and many other countries is heart disease.

Research indicates that moderate drinkers are less likely to suffer heart attacks than are abstainers or heavy drinkers. The first scientific study of the relationship between alcohol consumption and atherosclerosis was published in the Journal of the American Medical Association in 1904. Public awareness of the French Paradox in the early 1990’s stimulated increased interest in the subject of alcohol and heart disease. The French paradox is the perceived paradox that people in France suffer relatively low incidence of coronary heart disease, despite their diet being rich in saturated fats. ...

An exhaustive review of all major heart disease studies has found that "alcohol consumption is related to total mortality in a U-shaped manner, where moderate consumers have a reduced total mortality compared with total non-consumers and heavy consumers." Research also reports that the risk of a heart attack among moderate drinkers with diabetes is 52 percent lower than among nondrinkers and that the risk of dying in the four years after a heart attack is 32 percent lower among those who were moderate drinkers in the year before the attack.

A logical possibility is that many of the alcohol abstainers in research studies previously drank excessively and had undermined their health, thus explaining their high levels of risk. To test this hypothesis, some studies have excluded all but those who had avoided alcohol for their entire lives. However, the conclusion remained the same: moderate drinkers are less likely to suffer heart disease.

Another possibility is that moderate drinkers have more healthful lifestyles (making them healthier), higher economic status (giving them greater access to better foods or better healthcare), higher educational levels (causing them to be more aware of disease symptoms), etc. However, when these and other factors are considered, the conclusion again remains the same: moderate drinkers are less likely to suffer heart disease.

Given the strong epidemiological evidence that moderate drinking reduces heart disease, it becomes important to examine how alcohol might confer its cardiovascular benefits. Can alcohol’s protective affects be explained physiologically? Research suggests that moderate consumption of alcohol improves cardiovascular health in a number of ways, including the following.

I. Alcohol improves blood lipid profile. A. It increases HDL ("good") cholesterol. B. It decreases LDL ("bad") cholesterol.

II. Alcohol decreases thrombosis (blood clotting). A. It reduces platelet aggregation. B. It reduces fibrinogen (a blood clotter). C. It increases fibrinolysis (the process by which clots dissolve).

III. Alcohol acts through additional ways. A. It reduces coronary artery spasm in response to stress. B. It increases coronary blood flow. C. It reduces blood pressure. D. It reduces blood insulin level. E. It increases estrogen levels

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.

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 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.


Based on material adapted from AlcoholAndHealth



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