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 In fact, heart failure patients who consume up to seven drinks a
week may actually live longer than those who completely avoid
alcohol, researchers report in JAMA Network Open.
"If you're 65 and above and have had a diagnosis of heart failure
and previously consumed mild to moderate amounts of alcohol, you can
probably continue to do so without any harm," said senior study
author Dr. David L. Brown, a professor of medicine at Washington
University in St. Louis, Missouri. "And it may actually be
associated with some benefit in terms of longevity, although there
is no way to show cause and effect from this study. We found that
those who continued to consume moderate amounts of alcohol after
diagnosis lived almost a year longer than those who never consumed
alcohol."
But, Brown cautioned, "if you have never consumed alcohol, don't
start on the basis of this study."
Brown got the idea for the study when a patient in the hospital with
a new diagnosis of heart failure asked if he could continue to have
a cocktail every night.
Heart failure is diagnosed when the organ can't pump enough blood to
the body. There are a host of reasons why this can happen, Brown
said, including "having a heart attack that results in loss of heart
muscle function, longstanding high blood pressure, obesity, diabetes
and even drinking excessive amounts of alcohol."
To determine whether alcohol should be taken off the menu for heart
failure patients, Brown and colleagues looked at health records for
nearly 6,000 patients aged 65 and older who signed on to the
Cardiovascular Health Study between 1989 and 1993 at four sites in
the U.S. In that group were 393 individuals with a new diagnosis of
heart failure in the first nine years of follow-up.
Participants with heart failure were followed through June 2013 with
regular phone calls. Researchers found that 129 of the heart failure
patients continued to drink after they were diagnosed, with most of
them consuming the equivalent of one to seven drinks per week.
One drink was equal to 12 ounces of beer, a 6-ounce glass of wine or
a 1.5-ounce shot of spirits. Just 17 heart failure patients consumed
more than seven drinks a week. Of the 168 patients who abstained
from alcohol, just over half were former drinkers and the rest had
never been drinkers.
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After accounting for factors that could influence heart failure
progression, including age, sex, income, smoking history, diabetes
and history of heart or kidney disease, researchers found that
patients who continued to drink after their heart failure diagnosis
lived longer.
On average, the non-drinkers lived 2,640 days after their diagnosis,
compared with 3,046 days among those who consumed one to seven
drinks a week and 2,806 days among those who consumed more than
seven drinks a week.
Why would moderate drinking contribute to a longer life among heart
failure patients? "That's the $64,000 question. We don't have the
answer for that," Brown said.
"And we still don't know if alcohol is the primary reason people
lived longer," he added. "It may be that people who drink do it as
part of a social network and that is the benefit rather than the
alcohol."
The findings will help doctors counsel heart failure patients who
want to know if they can continue to drink, said Dr. Erin Michos of
the Ciccarone Center for the Prevention of Heart Disease at the
Johns Hopkins School of Medicine in Baltimore, Maryland.
But, Michos noted, the study doesn't apply to all heart failure
patients. "Their study was limited to those who had already survived
to at least 65 years . . . and the mean age of these heart failure
patients was 79 years; thus their findings cannot necessarily be
extrapolated to younger individuals who might have longer life
expectancies," she said in an email.
SOURCE: https://bit.ly/2Tfd6cU JAMA Network Open, online December
28, 2018.
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