The study authors cautioned that people with heart failure should
avoid alcohol, and that their study does not mean that others should
start drinking “with abandon.”
The results are based on observation over time, so they cannot prove
that moderate drinking protects against heart failure, they added.
“We don’t know if alcohol is protective or if people who drink a
little bit might do other things that might be contributing to their
better health,” said Dr. Scott Solomon of Harvard Medical School in
Boston, the study’s senior author.
While previous research has shown a link between mild to moderate
alcohol intake and lower risk of coronary heart disease, such as
heart attacks, “what we didn’t know was whether this would also
extend to heart failure even in patients who did not have prior
heart attacks,” Solomon said.
“We were concerned because there is some evidence that alcohol is
toxic to the heart directly,” he said.
A moderate amount of alcohol is less than some people might expect -
about seven drinks over the whole week. The study assumed that one
drink contained 14 grams of alcohol, which is the amount in a little
over five ounces of wine, 13 ounces of beer or 1.5 ounces of liquor.
The researchers used data from the large and ongoing Atherosclerosis
Risk in Communities Study, following 14,629 adults who were 45 to 64
years old at the start of the study in 1987. People who didn’t drink
at all made up 61 percent of those included in the analysis, though
19 percent were former drinkers. About 25 percent of the study
population drank up to seven drinks weekly, 8 percent averaged seven
to 14 drinks a week, 3 percent had 14 to 21 drinks weekly and 3
percent drank 21 or more.
Men who had up to 14 drinks weekly were 20 percent less likely than
abstainers to develop heart failure and women who drank up to 7
glasses weekly were 16 percent less likely, according to the results
in the European Heart Journal.
“If we were giving a drug and doing this in a trial and showing that
effect, people would say, okay that’s a modest reduction,” Solomon
told Reuters Health. “It’s simply not as robust for women,” he said.
“It could be women are smaller in general and so this might have to
do to some degree with body size. But also other factors with gender
in terms of how we metabolize alcohol,” he added.
A higher percentage of men and women developed heart failure if they
were former drinkers compared to those who never drank. Men and
women who drank 21 or more drinks weekly were also more likely to
die from other causes than those who didn’t drink that much.
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“The decision to stop drinking may not be random, it may be
influenced by other factors that might be related to risk of
illness,” said Solomon, who also directs Noninvasive Cardiology and
the Cardiac Imaging Core Laboratory and Clinical Trials Endpoints
Center at Brigham and Women’s Hospital in Boston.
Showing that link between a low to moderate amount of alcohol and
lower risk of heart failure (and not just heart attacks or stroke)
is a “novel” finding, said Dr. Andrew J. Sauer at the Center for
Heart Failure, Heart Transplantation, Mechanical Assistance at
Northwestern University Feinberg School of Medicine in Chicago.
“A lot of us in the heart failure community have been suggesting
something similar for patients,” said Sauer, who was not involved in
the study.
He pointed out that the researchers accounted for factors like age,
education, body mass index, smoking, cholesterol and high blood
pressure, which bolsters the suggestion that alcohol is what
protected people from heart failure.
But, the study did not show how often people were drinking daily or
whether they might have even had seven drinks in one night, he said.
Sauer also noted that many people pour seven or eight ounces of wine
when they drink, and people who could stick to a truly moderate
amount “are probably very disciplined” and might therefore have
healthier lifestyles.
“A little more alcohol in your diet is continuing to show up . . .
as a potential protector for cardiovascular events,” Sauer said.
“But until there is a trial where people are randomized to
abstaining or drinking low to moderate amounts, we’ll never know for
sure.”
SOURCE: http://bit.ly/1ESwcsk European
Heart Journal, online January 20, 2015.
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