Light drinking after heart attack may have benefits

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Moderate drinkers who continue the habit after suffering a heart attack may fare better than their counterparts who give up alcohol, a new study suggests.

Many studies have linked light-to-moderate drinking to a lower risk of developing heart disease, compared with both heavy drinking and abstention. The new findings, published in the American Journal of Cardiology, are the first to link moderate drinking after a heart attack to health benefits.

Researchers found that among 325 moderate drinkers followed for several years after having a heart attack, those who continued their usual drinking habits generally had better physical function than those who quit drinking. 

They also tended to have less chest pain and report a higher health-related quality of life, but those differences were not significant in statistical terms, so may have been chance findings.

The findings do not prove that moderate drinking is the reason for the better physical function.

But the results are in line with past studies pointing to health benefits from moderate drinking, particularly red wine, according to senior researcher Dr. James H. O’Keefe, of the Mid America Heart Institute of St. Luke’s Hospital in Kansas City, Missouri.

He said that heart attack patients who have always been moderate drinkers—up to a drink a day for women and up to two per day for men—should talk to their doctors about whether it is all right to continue that pattern.

“This study,” he said in an interview, “suggests that, unless their doctors tell them not to, they can continue to drink and feel good about it.”

The findings are based on data from 325 heart attack survivors treated at 19 U.S. hospitals who said they had been moderate drinkers before the attack. Overall, 84 percent kept up that drinking pattern, while 16 percent quit drinking.

One year after the heart attack, patients who were still drinking moderately generally had higher scores on a standard questionnaire of physical functioning—which gauges people’s ability to climb stairs, carry groceries and perform other day-to-day tasks.

Drinkers also had a lower death rate after three years—6 percent, versus 10 percent among quitters—and fewer repeat hospitalizations in the first year post-heart attack. However, when the researchers accounted for patient factors such as age and overall health at the time of the heart attack, moderate drinking itself was no longer strongly linked to lower death rates or hospitalizations.

In contrast, moderate drinking remained linked to better physical function even when other factors were considered. That, O’Keefe said, suggests that drinking may bestow the benefit.

He noted that studies have pointed to a number of mechanisms by which moderate drinking may do the body good—including raising “good” HDL cholesterol, reducing body-wide inflammation, and improving sensitivity to the blood-sugar-regulating hormone insulin.

O’Keefe cautioned, however, that heavier drinking is linked to a number of increased health risks compared with both moderate drinking and abstention. Heavy drinking can, for example, raise blood pressure, promote blood clotting and contribute to heart-rhythm disturbances.

Experts also generally do not recommend that non-drinkers start drinking for the sake of the potential heart benefits, as it is not possible to predict which non-drinkers might develop alcohol abuse problems.

SOURCE: American Journal of Cardiology, online April 26, 2010.

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