Many studies have suggested that light to moderate alcohol consumption has health benefits in the general population, including a lower risk for cardiovascular events like heart attacks. But there hasn’t been much research looking at whether people who already have cardiovascular disease also benefit from moderate drinking. For this analysis, researchers looked at data from 48,423 people who took part in various studies tracking alcohol intake and outcomes over time, including heart attacks and death due to cardiovascular disease. Two of the largest studies included in the analysis had follow-up periods lasting a median of about nine years, while the follow-up period varied in other studies that were included. Overall, 7,992 participants died during follow-up. The researchers constructed a statistical model to look at the relationship between alcohol intake and cardiovascular outcomes, controlling for other factors like age, sex, and smoking status.
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Light to moderate alcohol consumption linked to lower heart risk
For all outcomes included in the study — including cardiovascular events like a heart attack or stroke, death from cardiovascular disease, and death from all causes — the researchers found a J-shaped relationship between alcohol intake and the outcome. In other words, not drinking any alcohol was linked to a somewhat higher risk, which was reduced with light to moderate alcohol consumption. But with heavier alcohol consumption, the risk went up substantially.
For death from all causes, the lowest risk was seen with a daily alcohol intake of 7 grams per day, with a 21% lower risk compared with not drinking. For death from cardiovascular causes, the lowest risk was seen with a daily alcohol intake of 8 grams per day, with a 27% lower risk compared with not drinking. For cardiovascular events like a heart attack or stroke, the lowest risk was seen with a daily alcohol intake of 6 grams per day, with a 50% lower risk compared with not drinking — demonstrating an apparently very large protective effect from moderate drinking. In the United States, a standard drink is defined as containing 14 grams of alcohol, and is equivalent to a 12-ounce can of beer that is about 5% alcohol, a 5-ounce glass of wine that is about 12% alcohol, 1.5 ounces of 80-proof spirits or 1 ounce 100-proof spirits. So for each of the outcomes in the study, the lowest risk was seen with an average intake of less than one drink per day.
It’s possible, the researchers noted, that the benefits for moderate drinking aren’t as large as their analysis suggests. That’s in part because in a few of the studies included in the analysis, former drinkers were excluded, since they might not have the same cardiovascular risk profile as people who were always nondrinkers. In these studies, the relationship between moderate drinking and beneficial outcomes was smaller, suggesting that some of the apparently higher risks linked to not drinking might actually be due to having previously consumed larger amounts of alcohol.
Still, the researchers found that to optimize cardiovascular outcomes in people with a previous cardiovascular event, the evidence suggests that moderate drinkers don’t need to stop drinking. “However,” the researchers wrote wrote, “they should be informed that the lowest risk of mortality and having another cardiovascular event is likely to be associated with lower levels of drinking,” up to about 105 grams of alcohol per week, or an average of about one drink per day. Beyond this point, the cardiovascular risks of drinking alcohol appear to be clearly greater than those seen with not drinking at all.
Want to learn more about keeping your heart healthy with diabetes? Read “Tips for a Healthy Heart,” “Lower Your Risk of Heart Disease” and “Fight Off Heart Disease With These Five Heart-Healthy Foods.”