Heart attacks and other forms of coronary heart disease result in approximately 500,000 deaths annually, accounting for 25 percent of America's total mortality.
With few exceptions, however, data from at least 20 countries in North America, Europe, Asia, and Australia demonstrate a 20%-40% lower coronary heart disease incidence among drinkers compared with nondrinkers.
Red wine has been touted as beneficial for cardiovascular health, but new research suggests that while one glass of that favourite Merlot or Shiraz may indeed be heart healthy, two or more could actually do more harm than good over time.
The following brief video clip on alcohol and heart attack addresses this issue.
Click on the arrow in the center of the screen to begin viewing.
How Might Alcohol Lower Risk for Coronary Heart Disease?
To function normally, the muscle tissue that constitutes the bulk of the heart requires a constant supply of oxygen-containing blood. Blood is delivered to the heart muscle through the coronary arteries.
Cholesterol and other fatty substances can accumulate within the coronary arteries, partially impeding the flow of blood. This condition underlies the clinical manifestations of CHD, which may range from episodic chest pain to sudden death. The most common serious manifestation of CHD is the heart attack.
Heart attacks are generally triggered by the formation of a blood clot within a constricted coronary artery, obstructing blood flow and depriving a portion of the heart muscle of oxygen.
The resulting impairment of the heart's pumping ability may cause permanent disability or death, either immediately or through the progressive development of medical complications.
Researchers have investigated several theories to explain how alcohol itself might lower risk for CHD.
For example, alcohol may protect the heart by preventing the constriction of the coronary arteries, inhibiting clot formation, and enhancing recovery following a heart attack.
Alcohol may help prevent clot formation within already narrowed coronary arteries.
Clotting occurs partly in response to chemicals released into the blood from the arterial wall. Exposure of these cells to alcohol in the laboratory suppresses the production of substances that promote clotting and stimulates the production and activity of substances that inhibit clotting.
In addition, analyses of blood samples drawn from human volunteers indicate that alcohol consumption increases blood levels of anticlotting factors and decreases the "stickiness" of the specialized blood cells (i.e., platelets) that clump together to form clots.
Alcohol and Heart Attack
A Commentary by NIAAA Director Enoch Gordis, M.D.
Research findings continue to confirm an association between moderate drinking and a lower risk for coronary heart disease.
While there is an association between moderate drinking and lower coronary heart disease risk, science has not confirmed that alcohol itself causes the lower risk.
It also is plausible that the lower risk might result from some as yet unidentified factor or surrogate associated both with alcohol use and lower CHD risk, such as lifestyle, diet and exercise, or additives to alcoholic beverages.
Research is now in progress on the relation between alcohol and heart attack to answer these questions.
The distinction between an association and a cause is important, particularly when considering what advice to give to the public.
Further, even if we find that alcohol itself is responsible for the lower risk, still to be considered would be the trade-offs between the benefits and risks, particularly for specific subsets of the population.
For example, moderate drinking by older persons may lower coronary heart disease but increase risk for other alcohol-related health conditions, such as adverse alcohol-drug interactions; trauma, including falls and automobile crashes; or hemorrhagic stroke.
Until these issues are clarified, we continue to believe that the most prudent advice is the following:
(1) Individuals who are not currently drinking should not be encouraged to drink solely for health reasons, because the basis for health improvements has not yet been established as deriving from alcohol itself;
(2) Individuals who choose to drink and are not otherwise at risk for alcohol-related problems should not exceed the one- to two-drink-per-day limit recommended by the U.S. Dietary Guidelines; and
(3) Individuals who currently are drinking beyond the U.S. Dietary Guidelines' recommended limits should be advised to lower their daily alcohol intake to these limits.
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