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After a Heart Attack, Have an Alcohol Drink or Two

Alcohol can be beneficial after heart attack

After a heart attack, medical advice generally includes eating a healthy diet, not smoking, and engaging in suitable exercise, but what about drinking alcohol? Results of a new study published in the European Heart Journal indicate that men who have survived a heart attack and who consumed two alcoholic drinks daily had a 42% lower risk of death from cardiovascular disease than nondrinkers.

To drink or not to drink, that is the question

A growing number of studies have shown that moderate intake of alcohol, which is defined as up to two drinks for men and one drink for women per day, can have a positive effect on cardiovascular health. Indeed, moderate drinking has been associated with a number of health benefits (see “Health benefits of alcohol”).

Until this study, the effect of moderate drinking on heart attack survivors has been limited and uncertain, according to Jennifer Pai, an assistant professor of medicine at Brigham and Women’s Hospital and Harvard Medical School, and the study’s leader. No prospective study had evaluated alcohol consumption both before and after a heart attack and followed up long term after the attack.

That void in the research was filled with this new study. A total of 1,818 men were followed for up to 20 years from the time they experienced their first heart attack. All the men had participated in the US Health Professionals Follow-up Study, a prospective study that involved 51,529 male health professionals.

Every four years, all the participants were questioned about their alcohol consumption, diet, smoking habits, body mass index, and other lifestyle factors. The men were classified according to the amount of alcohol they consumed: 0 grams, 0.1 to 9.9 grams, 10.0 to 29.9 grams, and more than 30 grams daily. Moderate drinkers were those who consumed 10 to 29.9 grams daily.

The investigators observed the following:

  • Men who consumed about two alcoholic drinks daily over the long-term had a 14% lower risk of dying from any cause and a 42% lower risk of death from cardiovascular disease compared with nondrinkers
  • Men who drank moderate amounts of alcohol before their heart attack and who continued to drink moderately after their attack “also had better long term prognosis,” according to Pai.
  • Men who drank 30 grams or more per day had a risk of death from any cause that was similar to that of nondrinkers

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Pai and colleagues noted that their findings support the guidelines from the European Society of Cardiology, which notes that moderate alcohol consumption in men for long-term management of acute coronary syndromes “should not be discouraged and may be beneficial for long-term prognosis after heart attack.” At the same time, all patients should discuss their alcohol use with their physicians.

Health benefits of alcohol
The possibility that alcohol consumption can offer health benefits continues to be a topic of great interest among researchers and the public alike. Thus far, investigators have determined that moderate consumption may reduce the risk of developing heart disease, reduce the risk of stroke (especially ischemic stroke), lower the risk of gallstones, and possibly reduce the risk of diabetes.

It’s important to point out the definition of “moderate” alcohol consumption, as straying from this definition changes the potential for risks and health benefits. Heavy drinking is associated with high blood pressure, some cancers, heart disease, cirrhosis, and alcohol dependence.

One drink is defined as the following:

  • Beer: 12 fluid ounces
  • Wine: 5 fluid ounces
  • Distilled spirits (80 proof): 1.5 fluid ounces

The Harvard study did not include females, and as Pai explained, “we cannot extrapolate to women. However, in all other cases of alcohol and chronic disease, associations are similar except at lower quantities for women.” For men, however, the results of this study indicate that after a heart attack, having a drink or two may reduce the risk of dying.

Pai JK et al. Long-term alcohol consumption in relation to all-cause and cardiovascular mortality among survivors of myocardial infarction: the Health Professionals Follow-up Study. European Heart Journal 2012; doi:10.1093/eurheart/ehs047

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