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Moderate alcohol consumption has potential heart benefits

Moderate alcohol consumption reduces the risk of mortality following myocardial infarction, and is associated with a reduction in heart failure risk in the elderly, according to two US studies reported in the Journal of the American Medical Association.

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The first study determined the effect of prior alcohol consumption on long-term mortality among 1,913 early survivors of acute myocardial infarction (AMI).

Of the 1,913 patients, 47% abstained from alcohol, 36% consumed less than 7 alcoholic drinks per week, and 17% consumed 7 or more alcoholic drinks week.

Compared with abstainers, patients who consumed less than 7 drinks per week had a lower all-cause mortality rate (3.4 vs. 6.3 deaths per 100 person-years; hazard ratio [HR], 0.55). Those who consumed 7 or more drinks per week also had a lower all-cause mortality rate (2.4 vs. 6.3 deaths per 100 person-years; HR, 0.38).

After adjusting for propensity to drink, and other potential confounders, increasing alcohol consumption remained predictive of lower mortality for less than 7 drinks per week, with an adjusted HR of 0.79, and for 7 or more drinks per week, with an adjusted HR of 0.68.

Moderate alcohol consumption reduces infarct mortality and heart failure risk.
Journal of the American Medical Association

The association was similar for total and cardiovascular mortality, among both men and women, and among different types of alcoholic beverages.

Dr Kenneth Mukamal, of the Beth Israel Deaconess Medical Center, Boston, concluded, "Self-reported moderate alcohol consumption in the year prior to AMI is associated with reduced mortality following infarction."

In the second study, researchers determined whether moderate alcohol consumption predicts heart failure risk among older persons, independent of the association of moderate alcohol consumption with lower risk of myocardial infarction (MI).

The researchers enrolled a total of 2,235 elderly persons (mean age, 73.7 years) who were free of heart failure at baseline.

Increasing alcohol consumption in the moderate range was found to be associated with decreasing heart failure rates.

For persons consuming no alcohol (50%), 1 to 20 oz (40%), and 21 to 70 oz (10%) in the month prior to baseline, crude heart failure rates per 1,000 years of follow-up were 16.1, 12.2, and 9.2, respectively.

After adjustment for confounding factors, the relative risks of heart failure for those consuming no alcohol, 1 to 20 oz, and 21 to 70 oz were 1.00 (referent), 0.79, and 0.53.

Dr Jerome Abramson, of the Emory University School of Medicine, Atlanta, Georgia, concluded, "Increasing levels of moderate alcohol consumption are associated with a decreasing risk of heart failure among older persons.

"This association is independent of a number of confounding factors and does not appear to be entirely mediated by a reduction in MI risk."

JAMA. 2001; 285: 1965-70

JAMA. 2001; 285: 1971-7

Journal of the American Medical Association
24 April 2001

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