August 22, 2018

expert reaction to research on moderate drinking and heart disease

Researchers, publishing in BMC Medicine, looked at alcohol consumption and risk of heart disease. They reported that unstable drinking patterns were associated with higher risk of heart disease than consistent alcohol consumption within the recommended guidelines.

Prof David Spiegelhalter, Winton Professor for the Public Understanding of Risk at the University of Cambridge, said:

“This study showed that moderate drinkers experienced around a third less heart disease than non-drinkers, even when excluding ex-drinkers. But it does not mean that moderate drinking actually caused all this difference. Some habitual teetotallers may be just less healthy, and in a way that is not taken into account by all the factors used in statistical adjustment.”

Prof Naveed Sattar, Professor of Metabolic Medicine at the University of Glasgow, said:

“This is an interesting report but it is nothing new and the headline message misses the fact that a much bigger recent study published in the Lancet has shown that whilst risk for myocardial infarction may well be lower with modest alcohol, risk for other complications of the heart and brain increase with even moderate drinking.  Indeed, drinking about the recommended levels of around 5 drinks per week was linked to increased risks of stroke, fatal aneurysm, heart failure and death.  Thus a lower heart attack rate misses the fact that overall, drinking beyond around 12 units per week will increase overall risks.  Indeed, our conclusions from the previous paper was that if you drink, drinking less may help you live longer and lower risk of several vascular complications.

“In short, no one should start to drink or drink more to protect their hearts.  The totality of evidence does not support alcohol as a measure to improve overall risks.”

Victoria Taylor, Senior Dietician at the British Heart Foundation said:

“While this meta-analysis can find links, it can’t say there is cause and effect between alcohol consumption and heart disease. Some of the data relies on self-reported alcohol intake, and there may be national and regional data collection variations, which could mean the results can’t be generalised to reflect the wider UK population. There was also no information about drinking habits before this study began, nor about why people did not drink alcohol or why they gave it up during the study, which also could have been linked to their health. As the authors themselves point out, the observation of no link between heavy drinking and heart disease should be interpreted with caution given the relationship between heavy drinking and several other diseases.

“There is a balance to be sought between the risks and benefits of alcohol consumption. While there may be some benefits to heart disease from alcohol consumption, we must bear in mind that there may be implications for other circulatory conditions, such as stroke and vascular dementia, as well as for cancers. In reality, you can’t separate your heart health from your general health and there are much safer ways to reduce your risk of heart disease, like keeping fit and eating well. If you do drink, keep within the limit of no more than 14 units a week for both men and women.”

* ‘Association  of  longitudinal  alcohol consumption  trajectories  with  coronary heart  disease:  a  meta-analysis  of  six  cohort studies  using  individual  participant  data’ by Dara O’Neill et al. was  published in BMC Medicine on Wednesday 22 August.

Declared interests

None received.