Dr. Day is a cardiologist and Medical Director of Heart Rhythm Services at his practice in Salt Lake City, Utah. He graduated from Johns Hopkins Medical School and completed his residency and fellowship in cardiology at Stanford University. He is board certified in Cardiology and Cardiac Electrophysiology.
Could a recent study that hit worldwide news, provide enough evidence to overturn the long-held belief that a little alcohol is good for the heart?
According to the Center for Disease Control (CDC), one in ten deaths of working age adults in the U.S. results from alcohol consumption. Despite this fact, many in the medical community have been telling us for years that a little bit of alcohol is good for us as it prevents coronary heart disease (plaque build up in the arteries of the heart).
What are the effects of alcohol on the heart? Is there a link between alcohol and heart disease?
This recommendation to drink a little bit of alcohol did not come from high quality studies. This recommendation came from observational studies based on how much alcohol people said they drank. So many of us wanted to believe that this vice could actually be healthy for us, so few questioned if this was even true or not. This groundbreaking and scientifically rigorous study of 261,991 people hit worldwide news demonstrating that any alcohol may be hazardous to your heart health.
My Previous Alcohol Recommendations to Patients
For years I have struggled with this alcohol conundrum in counseling cardiac patients. On one hand, alcohol, especially red wine, appeared to be very effective in preventing plaque build up in the heart. This was the “heart” of the so-called “French Paradox” where supposedly their red wine protects their hearts from their high saturated fat diet.
On the other hand, I have personally seen, and the tragic data shows, that alcohol destroys many families, and causes liver failure and cancer. While alcohol was believed to prevent coronary heart disease, it is a known cause of heart failure and the most common cardiac arrhythmia, atrial fibrillation. I struggled as to how I could best counsel my patients on the subject of alcohol.
With regards to alcohol and heart disease, my conclusion at the time was to advise limiting alcohol to one drink daily, if they drank, preferably a red wine. This way we could potentially minimize any negative bad effects of alcohol on the heart.
If they did not drink, I never encouraged drinking to prevent coronary heart disease. Lastly, if they suffered from heart failure or atrial fibrillation I recommended that they stop drinking.
I advised such based on the available data—it was all we had. I now advise differently, as the latest study provides new findings.
Any Alcohol is Dangerous to the Heart Study
This study is very important in that it is much more scientifically rigorous than previous studies. The data behind the alcohol recommendation to prevent coronary heart disease was based on observational studies. Observational studies have to be taken with a grain of salt because there are so many confounding factors which researchers cannot control.
Could observational study bias explain the alcohol protective dogma that the medical community has believed for so long? Do we need to worry about alcohol and heart disease?
In this study, first author Dr. Michael V. Holmes from the Perelman School of Medicine in Philadelphia, Pennsylvania and colleagues took a different approach. Rather than just doing yet another observation study based on the subjective recall of how much alcohol everyone drank, they looked at whether or not people had the ADH1B gene.
The ADH1B gene codes for the alcohol dehydrogenase 1B enzyme which breaks down alcohol in the body. People with this enzyme rapidly metabolize alcohol which results in nausea, facial flushing, and not feeling well when they drink alcohol. As a result, most people with the ADH1B gene drink very little alcohol or they abstain altogether.
In this study, Dr. Holmes and his colleagues had the brilliant idea to look at the clinical outcomes of 261,991 people in this international study to see if this gene could predict clinical outcomes.
Interestingly, people who genetically cannot tolerate alcohol were less likely to:
• Be overweight
• Have high blood pressure
• Have significant levels of inflammation
• Have a heart attack
• Have a stroke
Overnight, this study has challenged the long-held dogma that alcohol might somehow be good for the heart. We now have a pretty good idea about the effects of alcohol on the heart.
Our Experience in China’s Longevity Village
This study supports our findings during our stay among the residents of China’s Longevity Village. Based on our research in China’s Longevity Village, which is a rural mountain village in Southwest China near the Vietnam border, most of these long-lived people completely abstain from alcohol. These people were historically water drinkers.
This abstinence is largely based on their extreme poverty and geographic isolation from China and the rest of the world. In fact, based on studies of these long-lived people, 64% of the people completely abstain from alcohol. Could this be one factor, among many, that contributed to their long lives and freedom from the chronic medical conditions from which so many of us here in the U.S. suffer? We delve into our findings in China’s Longevity Village, and their implications for our own lives here in the U.S., in our book scheduled for publication next year.
My New Alcohol Recommendations to My Patients
The results of the more than 260,000 people in this study demonstrate that alcohol does not have any protective effect to the heart. In my opinion, given the many tragic outcomes of alcohol consumption, the less alcohol we drink the better. For my patients who have developed any form of heart disease, I now encourage them to avoid or minimize alcohol consumption.
Not only is it this study, another mega study just came out in the July 22, 2014 issue of Journal of the American College of Cardiology showing that any alcohol can be a significant cause of a dangerous heart rhythm abnormality called atrial fibrillation.
What do you think? Is this study strong enough to overturn the long held belief that alcohol is somehow protective for the heart? You can leave a comment by clicking here.
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