Page last updated: Friday, August 15, 2008
Teetotallers who begin to drink reduce their risk of cardiovascular disease
Researchers at the Medical University of South Carolina have found that middle-aged non-drinkers who began drinking in moderation experienced a 38% lower risk of developing cardiovascular disease compared to those who continued abstaining.

The medical researchers studied 7,697 people between 45 and 64 who were non-drinkers and who were participating in the Atherosclerosis Risk in Communities (ARIC) study over a 10 year period. The investigators found that 6% began consuming alcohol in moderation (up to one drink per day for women and up to two drinks per day for men) during the follow-up period. After 4 years of follow-up, new moderate drinkers had a 38% lower chance of developing cardiovascular disease than did the non-drinkers. Even after adjusting for physical activity, Body Mass Index, demographic and cardiac risk factors, this difference persisted.

This study is important in that it provides more evidence that the reduced risk of cardiovascular disease among moderate drinkers is a result of the alcohol itself rather than any differences in lifestyle, genetics, or other factors.

Source: King, Dana E., Mainous, III, Arch G. and Geesey, Mark E. Adopting moderate alcohol consumption in middle-age: Subsequent cardiovascular events. American Journal of Medicine, 2008 (March), 121(3).

rticle shows first that, regardless of alcohol intake, subjects with a greater number of healthy lifestyle factors have lower rates of MI than subjects with fewer healthy factors (e.g., much higher risk of MI for subjects with 0 or 1 of the factors than for those with more). However, going from consuming zero alcohol to 15-29.9 g of alcohol per day results in a marked decrease in the risk of MI for all groups. For example, among subjects with 4 healthy factors (lean, active, non-smokers on a healthy diet), the rates for MI appear to be about 270 for non-drinkers and just over 100 for consumers of 15-29.9 g/day. There were few subjects in some of the categories, but the overall pattern of alcohol effect was the same in all groups.

The investigators also evaluated men who met criteria for only three of the components of a healthy lifestyle and estimated the effect if they added another healthy factor. The estimated effect of stopping smoking was the single change in lifestyle that gave the greatest benefit on risk of MI. However, the estimated effect of alcohol was the same or greater than those associated with the other three lifestyle factors (consuming an optimal diet, becoming physically active, or achieving optimal weight). The investigators did not have sufficient numbers to evaluate changes in alcohol consumption over time, but other studies have shown that the risk of MI tends to increase when people stop drinking and to decrease when they begin to drink.

It is important to appreciate the marked differences in rates of MI by all of the “healthy lifestyle” factors. In the figure above, for example, going from 0-1 to 4 such factors reduced the risk of MI from almost 600 to below 300. Thus, all of the factors are important in lowering the risk of MI (and the risk of most other diseases). Still, regardless of other factors, moderate alcohol makes a large and significant contribution to a lowering of risk of MI.

Lay Summary: This paper from the Health Professionals Follow-up Study shows that there is a reduction in the risk of myocardial infarction (MI) with moderate drinking regardless of other healthy lifestyle factors. The study demonstrated that even among very “healthy” men (i.e., lean non-smokers who exercised regularly and had a healthy diet), those consuming about 1 to 2 _ drinks per day had 62% lower risk of MI than subjects with the same healthy lifestyle who did not consume any alcohol. These results tend to refute the oft-quoted hypothesis that lower coronary heart disease seen among moderate drinkers is due to their associated healthy lifestyle habits, and not to their alcohol consumption.

Article: Mukamal KJ, Chiuve SE, Rimm EB. Alcohol consumption and risk for coronary heart disease in men with healthy lifestyles. Arch Intern Med 2006;166:2145-2150.

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