Heart 411 - Alcohol's Effects On The Heart
This Is Your Heart on Alcohol
Alcohol in moderation can be good for your heart in surprising ways and may help you reach healthy cholesterol levels.
By Tammy Worth
Medically Reviewed by Robert Jasmer, MD
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Most people are aware of the obvious effects of alcohol on the body. Drinking too much can alter your judgment and reflexes and, over time, cause weight gain and lead to alcoholism and chronic liver disease.
But the complex relationship between alcohol and the heart is not well understood, mainly because it's not a simple association.
Like many drugs, alcohol can be good or bad, depending on the circumstances. Experts and research seem to agree that imbibing in moderation can benefit your heart if you don’t already have a heart condition like atrial fibrillation.
But drinking too much can cause a weakened heart, known as alcoholic cardiomyopathy, or trigger an irregular heart rate called atrial fibrillation. Rarely, alcohol can lead to an irregular heart rhythm that's sometimes fatal, known as ventricular tachycardia. Drinking in excess also increases the risk of developing other problems, including high blood pressure and stroke, and can cause dependency, notes the American Heart Association.
Alcohol’s Effects on Your Heart
There is no hard and fast data showing exactly what happens to the heart when we drink. Steven Nissen, MD, chair of the department of cardiovascular medicine at the Cleveland Clinic in Ohio, says that this is because most research in this area is observational; so far, these studies have shown no direct cause-and-effect relationship
“Broadly powerful agents like alcohol do a lot of things in the body, and we don’t know exactly what is responsible for the benefits,” Dr. Nissen says.
But when adults drink in moderation, Nissen says, the heart appears to benefit in three ways:
- Higher HDLDrinking in moderation can raise HDL, or “good” cholesterol.
- Reduced ClottingAlcohol can act as an anticoagulant, making the blood less sticky and less likely to clot.
- Less InflammationAlcohol may also reduce inflammation, which plays a role in heart attacks and strokes.
In an extensive review of more than 100 studies dealing with alcohol intake and heart disease, researchers at the Harvard T.H. Chan School of Public Health in Boston found that moderate drinkers had a 25 to 40 percent reduced risk of heart attack, stroke, peripheral vascular disease, and death from cardiovascular causes compared to nondrinkers.
The Wine Myth
It's a widely held belief that red wine is the healthiest type of alcoholic beverage because it contains resveratrol, a powerful antioxidant. But one type of alcohol may be as good for the heart as another.
“There is not one shred of evidence that it [resveratrol] does anything,” Nissen says. “And if it does, it was in studies on animals. People would have to drink liters of red wine every day to do anything.”
The American Heart Association notes that benefits attributed to wine could actually be due to other dietary habits of those who drink wine, like eating plenty of fruits and vegetables, but fewer fats.
Overall, moderate consumption of alcoholic drinks is linked to lower heart disease risk, but wine doesn’t have any more cardio-protective benefits than beer or spirits, according to an extensive review of clinical studies published in March 1996 in theBritish Medical Journal.
And a study published in July 2014 in theThe Journal of the American Medical Associationfound that having higher levels of resveratrol in the urine from foods like red wine or grapes didn't influence inflammation, cardiovascular disease, or mortality in adults ages 65 and older.
Cardiologist Michael Blazing, MD, director of outpatient services and associate professor of medicine at the Duke University School of Medicine's heart center in Durham, North Carolina, says red wine may have some antioxidants that beer and hard liquor do not, but you can get the same antioxidants with grape juice.
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Drink Alcohol in Moderation
One of the key points to remember with alcohol is that moderation is crucial. According to the National Institutes of Health, for healthy people, low-risk drinking means no more than seven drinks in a week. And in any one day, low-risk means no more than four drinks for men, and no more than three for women.
What constitutes one drink?
- 12 ounces (oz) of beer (5 percent alcohol)
- 8 to 9 oz of malt liquor (7 percent alcohol)
- 5 oz of wine (12 percent alcohol)
- 1.5 oz shot of 80-proof spirits, like whiskey, gin, rum, or vodka
Most studies have been performed on middle-aged people. Those over age 65 metabolize alcohol differently, so they should have less alcohol.
“Two beers at 70 is about the same as four drinks at 50,” Nissen says. “What we tell patients is, if they choose to have a drink a day good for heart health, that’s fine.”
But research shows that too much of a good thing gets risky. One study out of the University of Rochester Medical Center in Rochester, New York, illustrates the different effects of moderate drinking and binge drinking. Researchers fed mice the equivalent of either two drinks daily, seven drinks on two days of the week (simulating weekend binge drinking), or no alcohol.
Compared to the mice that had no alcohol, mice that had moderate alcohol showed 40 percent lower levels of LDL, or bad cholesterol, in lab tests. In addition, HDL cholesterol increased after moderate alcohol intake. And further, the amount of plaque in the arteries was reduced, as was inflammation. The mice given high levels of alcohol (equivalent to seven drinks, two days per week) also had an increase in good cholesterol, but the other markers for heart disease, like bad cholesterol, increased, too — by 20 percent — while plaque and the number of inflammatory cells grew.
For people, drinking too much alcohol can cause a number of health problems. Blazing notes that occasionally having an extra drink or two for celebratory purposes is fine. But there are also times when you shouldn't have any alcohol at all.
For example, when a patient has an alcohol-related disease like liver damage or hepatitis C, they should never drink. And people on certain drugs, like narcotics and benzodiazepines (for anxiety), should also avoid alcohol, Blazing says. Mixing alcohol and blood thinners, a type of medication often used to treat deep vein thrombosis or atrial fibrillation, can increase the chance of intestinal bleeding.
“Drinking too much is not healthy for your heart or any other part of your body,” Blazing says. “If you drink, a little bit is good.
Video: Alcohol And The Heart
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