Alcohol & Coronary Heart Disease

Overview

According to the American Heart Association, coronary heart disease (also called coronary artery disease, CHD or CAD) accounts for over 25 percent of all deaths in the United States. Nine million men and women suffer from angina pectoris and over 7.9 million have heart attacks. Aerobic exercise, a heart healthy diet and moderate alcohol consumption can help to reverse this trend and lower your risk for heart disease.

Epidemiology CHD and Alcohol

Epidemiological data from studies conducted in North American, Asia, Australia and Europe suggest that moderate consumption of alcohol in any form, can lower an individual's risk for coronary heart disease. The longest and most famous study concerning how alcohol impacts CAD is the Framingham Coronary Heart Disease Study that was published in the "American Journal of Epidemiology" in 1986. Over one million men and women were studied over a 24-year period. The results indicated that non-smoking, moderate drinkers had a lower risk for coronary heart disease than total abstainers and heavy drinkers. Moderate drinking is defined at one to two alcoholic beverages per day. Beer and wine showed greater preventative benefits than spirits.

Causal or Incidental Benefits of Alcohol

Exactly how alcohol lowers your risk for heart disease isn't entirely understood. One argument is that alcohol itself contains elements that decrease the risk for coronary artery disease (see discussion below). Another argument is based on the lifestyle choices of moderate drinkers. Studies have shown that moderate drinkers often make better health-related choices with regard to their diets and exercise than heavy drinkers or people that completely abstain from alcohol.

A 1990 study by Berlin and Colditz found that the incidence of CAD was lower in people who had more physically active jobs and lifestyles. People who are physically active have a tendency to be within their optimal weight range and are at less risk for obesity and diabetes. Moderate drinkers also ate diets that were lower in saturated fat and cholesterol, further reducing the risk for heart disease.

How Alcohol Lowers CHD Risk

The coronary arteries supply blood to the heart. The heart depends on an uninterrupted supply of blood to pump blood to vital organs and other areas of the body. When the supply is restricted, angina or a heart attack follow. The principle cause of the shortage of blood to the heart is occlusion of the coronary arteries due to the built-up calcified plaque and blood clots inside the arteries.

Alcohol appears to have an anti-clotting effect on the blood and reduces the viscosity of the red blood cells. It has been shown to relax, or prevent the constriction of coronary arteries. Alcohol has also been shown to curtail the re-perfusion of blood in injured hearts in certain types of animals. Re-perfusion is the sudden restoration of blood flow to the heart and can cause damage to an already weakened heart muscle.

Choice of Beverages

There have been a number of conflicting results regarding which type of alcohol is better. Some studies indicate that red wine offers more value in limiting heart disease than beer or spirits. Data from 21 countries suggest that red wine is more highly correlated to lower risks for CAD than other types of alcoholic beverages. Other studies suggest that red wine drinkers practice other positive lifestyle practices and tend to smoke and drink less and eat healthier diets than people who drink white wine, beer or spirits.

Summarizing the Results

Should you drink alcoholic beverages to lower your risk for heart disease? That remains a personal decision. Certainly, anyone who enjoys a daily glass of wine or cocktail with dinner may have reason to celebrate. On the other hand, people who do not drink should not use this evidence to start drinking alcohol. Contrary to its CAD benefits, alcohol consumption can lead to cancer, cirrhosis of the liver and significantly contributes to premature death by automobile accidents.