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Alcohol and the Heart: Some good news

Posted by medconsumers on December 16, 2010

Moderate alcohol consumption is good for the heart but heavy drinking has the opposite effect. That’s a simplified summary of the research so far, though some will quibble over the definition of moderate. A new study fills in some missing information about how “drinking patterns” affect heart disease. It compared middle-aged male drinkers in France and Belfast, Northern Ireland, and found that heavy or binge drinking raises the risk of heart disease. But regularly drinking the same amount of alcohol over the course of several days is associated with a low risk of heart disease.

Belfast and France were chosen for study because alcohol consumption is the highest recorded worldwide. Most (91%) of the men in France and nearly two-thirds (60%) in Belfast reported drinking alcohol at least once a week, according to an international study reported online in the BMJ. There is, however, a big difference in the rate of heart disease, which is high in Northern Ireland and low in France. The study concluded that the radical difference in drinking patterns may account for the difference in heart disease rates. Regular and moderate alcohol intake throughout the week is the typical pattern for the Frenchmen. Alcohol consumption for the Belfast was confined largely to one day of the week—Saturday.

The study is based on the data generated by a large research project called the Prospective Epidemiological Study of Myocardial Infarction (PRIME), which included 2,405 Belfast men and 7,373 Frenchmen. All were in their fifties and initially free of heart disease when enrollment began in 1991. They were given periodic physical exams and asked to fill out extensive questionnaires about their health and lifestyle. Drinking habits were elicited from the participants in interviews, medical records, and questionnaire responses.

Of those who said they drink, 12% of the Belfast men and 75% of the Frenchmen said they drink every day. The mean consumption of pure alcohol was just under an ounce a day in Belfast and just over an ounce a day in France. Men were classified as binge drinkers if they reported regularly drinking four or five (6-ounce) glasses or more of wine or half pints of beer on a single day. Very few of the Frenchmen met this definition of binge drinkers (0.05%), compared with the Belfast men (9%). At about an ounce a pure alcohol a day, nearly all the Frenchmen were classified as steady or moderate drinkers.

After ten years of followup, the binge drinkers had twice the rate of heart disease as those who reported “regular and moderate” alcohol intake throughout the week. The study did not answer the question of which alcoholic beverage is best for the heart—wine, beer, or spirits. Its results came down in favor of red wine, but that’s only because this was the drink of choice for middle-aged Frenchmen in the 1990s. The Belfast men tended to drink beer or spirits. This study is not the last word on drinking patterns as key to the alcohol/heart disease puzzle. The authors concede that other factors like lifestyle and diet could account for the Frenchmen’s low risk of heart disease.

Maryann Napoli, Center for Medical Consumers(c)

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