Alcohol and the heart

Drinking in moderation is considered to be one of the five heart healthy lifestyle components, together with not smoking, eating a diet low in saturated fats, red meats and high in vegetables grains and fruit (The Mediterranean style diet) staying slim and exercising regularly. Drinking excessively, however, increases your risk of high blood pressure, atrial fibrillation, heart disease and hemorrhagic stroke.

Despite the impressive decline in death from heart disease in Canada over the last decade )(a reduction of 40%), diseases of the heart and circulatory system (CVD) are still the main cause of death. Every 7 minutes in Canada, someone dies from heart disease or stroke (Statistics Canada, 2011c).Heart disease and stroke are two of the three leading causes of death in Canada. Nine in 10 Canadians (90%) have at least one risk factor for heart disease or stroke (smoking, excess alcohol consumption, physical inactivity, obesity, high blood pressure, high blood cholesterol, diabetes) (PHAC, 2009).

Cardiovascular disease accounted for (Statistics Canada, 2011c): 28% of male 30% of female deaths in Canada (69,703 deaths)54% were due to ischemic heart disease 23% to heart attack and 20% to stroke. About 80% of strokes are ischemic caused by the interruption of blood flow to the brain due to a blood clot and 20% of strokes are hemorrhagic caused by uncontrolled bleeding in the brain.

The British Heart Foundation states in its October 2010 statistical report 'While moderate consumption (one or two drinks a day) does not increase the risk of CVD, it is estimated in men that 2% of CHD and 5% of stroke is due to excessive drinking. The impact of alcohol consumption in women in developed countries was estimated to be positive - that is, if no alcohol were consumed, there would have been 3% increased CHD and a 16% increase in stroke'. The Heart and Stroke foundation in Canada endorses The Canadian Low Risk guidelines (click here) http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3484033/k.2811/Heart_disease__Excessive_alcohol_consumption.htm

How does alcohol protect my heart?

The protective effect applies to those men over 40 and post menopausal women, where the risk of heart disease is higher. It is all a matter of dose: a daily drink, in any form, favourably alters the balance of fats or lipids in the blood, by stimulating the liver to produce the 'good' high density lipoprotein cholesterol (HDL). HDL removes the 'bad' low density lipoprotein cholesterol (LDL) from arteries and veins for disposal via the bile, which is referred to as reverse cholesterol transport.

Alcohol also inhibits excessive coagulation or the clotting together of red blood cells by reducing their ‘stickiness’, and facilitates the breakdown of blood clots. Drinking alcohol with a meal can reduce the sudden rise of a protein called fibrinogen produced by the liver. Fibrinogen increases the likelihood of harmful blood clots forming, called thrombosis.

Cardiologist Dr. Matt DeVane explains the potential benefits of alcohol for your heart and emphasizes the importance of moderation

The evidence base for the Canadian low risk drinking guidelines state . 'Low levels of consumption have also been connected with health benefits resulting in lower levels of illness and premature death. notably from ischemic heart disease. ischemic strokes and diabetes... the zero net risk point compared with lifetime abstainers at which the risks and benefits balanced each other out was two drinks on average per day for women and three for men'. Source: Alcohol and Health in Canada, a summary of evidence and guidelines for low risk drinking 2010.

Drinking more than responsibly (click here for guidelines) does not increase the protective effect - and only leads to long term health harms. Drinking heavily can lead to irregular heart beat, sudden heart death and significantly increases the risk of a hemorrhagic stroke.

The Mediterranean diet

Studies have shown that a healthier, ‘Mediterranean’ type diet, high in fruits, vegetables, fish, salad and olive oil and including alcohol in moderation, leads to greater longevity and a significant reduction in heart disease, late on set diabetes and stroke. The Lyon Heart Study found that this type of diet, combined with moderate wine consumption, might prevent a second heart attack in middle-aged men. Compared to non-drinkers, men drinking two glasses of wine a day reduced their risk of a second heart attack by 59%. Following the five heart healthy lifestyle factors of staying slim, not smoking, exercising gently daily and eating a balanced diet high in fibre, fruit and vegetables and low in saturated fats and drinking between 1/2 and two drinks a day, more than halves the risk of heart disease, type 2 diabetes and stroke.

Conversely, binge drinking, which is considered to be the consumption of more than 6 drinks per drinking session, is seen to significantly increase systolic blood pressure, which significantly increases the risk of coronary heart disease or stroke.

Drink with food

Accompanying alcohol intake with food not only decreases the effect of alcohol (lowers the higher blood alcohol level associated with drinking on an empty stomach), but helps counter damaging free radicals. Rich foods increase the state of “oxidative stress” in the body. Dietary antioxidants, including those from red wine, can help reduce the oxidation of cholesterol and lipoprotein, both implicated in cardiovascular disease. Research shows that drinking outside of meal times increases the risk of high blood pressure; and, along with abstinence, is associated with greater all cause mortality.

Stroke

Stroke is one of the leading causes of death and disability in the developed world. While heavy alcohol consumption appears to increase the risk of all types of strokes, moderate drinkers have a reduced risk of stroke compared to non-drinkers and heavy drinkers. Ischaemic strokes account for 85% of strokes. They are caused by blockage of a blood vessel by a clot, which starve the brain of blood and hence oxygen. The anti-coagulatory (clotting) effect of alcohol lasts for approximately 24 hours, and hence regular moderate alcohol consumption is necessary to maintain a reduced the risk of ischaemic stroke.

What the experts say...

The National Stroke Association Prevention Advisory Board states that “studies now show that drinking up to two drinks per day can reduce your risk for stroke by about half. More alcohol than this can increase your risk for stroke by as much as three times.”

Please note, however, that drinking heavily significantly increases the risk of a hemorrhagic stroke.

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