There has been a belief that drinking small to moderate amounts of alcohol might provide a benefit to the cardiovascular system. Unfortunately for believers in that myth, new powerful scientific evidence debunks it.
I honestly never bought into it because it always seemed to be one of those medical myths that were never really supported by robust and repeated evidence. But it hung around for so long that even cardiologists thought that drinking moderate amounts of alcohol reduced the risks of cardiovascular events.
Drinking alcohol, even in moderate amounts, has a lot of deleterious effects like increasing the risk of cancer. So, maybe we should consider drinking alcohol to be along the lines of smoking cigarettes — evidence-based links to cancer, mental health, cardiovascular disease, and so much else. I know that I’m advocating a very unpopular point of view, but I’m into the science, not the societal, points of view.
So let’s take a critical look at this paper, and determine if it really does debunk the myth about alcohol and cardiovascular disease.
Alcohol and cardiovascular disease article
In a paper published on 22 March 2022 in JAMA Network Open, Krishna G Aragam, MD, MS of Harvard University and colleagues researchers examined nearly 400,000 people who participated in the UK Biobank, a British database of genetic information that allowed investigators to study genes and their relationships to health. The average age of subjects selected for the alcohol study was 57 years, and the subjects reported consuming an average of 9.2 drinks per week.
Researchers in the past have reported that drinking modestly was correlated with a lower risk of heart disease compared to those who drank heavily or who did not drink. However, and we see this in many nutritional and lifestyle studies, it wasn’t the drinking that protected the heart, it was that the group who consumed up to 14 drinks per week tended to have other characteristics that decrease cardiovascular risk like lower rates of cigarette smoking, less obesity, and more exercise compared to those who drank more or less.
Researchers have found genetic variants that predispose a person to heavier or lighter drinking. Because the variants are distributed randomly in a population, they can serve in a study as the equivalent of randomly assigning people to abstain or to drink at varying levels. Researchers can ask if those with variants that are linked to greater alcohol consumption have more heart disease and high blood pressure than those with variants linked to lower consumption.
The researcher’s analysis showed an exponential curve of risk with the gene variants that suggest they drink more. The risks of heart disease and high blood pressure started slowly as the number of drinks increased, but they quickly gained steam, soaring as people got into the abusive drinking range of 21 or more drinks a week.
Overall, the researchers found that there is no level of drinking that does not confer heart disease risk. The risk is small if people have an average of seven drinks a week when compared with none. But it increases quickly as the level of alcohol consumption rises.
Most studies that examined the link between drinking and cardiovascular disease were observational — researchers would follow a group detailing their drinking habits and matching that to cardiovascular risk. At best, this type of study can show correlation, but not causation.
But Aragam and his colleagues used Mendelian randomization, that is, using measured variation in genes to randomize the level of drinking, which can be much more suggestive of causality. And these results should carry more weight with cardiologists who try to advise their patients with the best information possible.
I know some of you are going to read this article and say, “science keeps changing its mind on this. First, they said to drink alcohol to protect my heart. Now, they say don’t do that.”
Well, I’d reply that science is not dogmatic. Medicine changes with evidence, and in this case we have strong causal evidence that alcohol increases the risks of cardiovascular disease even in moderate amounts, but it also increases quickly the more you drink.
And given that even moderate amounts of alcohol increase the risk of cancer, maybe it is time to start warning people who are at risk of cardiovascular disease to begin to refrain from drinking.
- Biddinger KJ, Emdin CA, Haas ME, Wang M, Hindy G, Ellinor PT, Kathiresan S, Khera AV, Aragam KG. Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. JAMA Netw Open. 2022 Mar 1;5(3):e223849. doi: 10.1001/jamanetworkopen.2022.3849. PMID: 35333364; PMCID: PMC8956974.
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