Moderate Alcohol Use Lowers Risk Of Deadly Second Heart Attack

November 12, 1997

ORLANDO, Nov. 12 -- Drinking moderate amounts of alcohol -- about one drink a day -- cuts the risk of a deadly heart attack in men who already had one heart attack or stroke, according to a study reported today at the American Heart Association's 70th Scientific Sessions.

"We found a clear reduction in the risk of death in light to moderate drinkers compared to people who didn't drink at all," reports J. Michael Gaziano, M.D., director of cardiovascular epidemiology at Boston's Brigham and Women's Hospital, who led the study.

"If you drink half a drink per day, you're not likely to derive greater benefit from drinking two drinks per day," says Gaziano. "Since this study included only men, similar studies will have to be done in women."

Does this mean the physicians should advise heart patients to drink? Because heavy drinking can damage heart muscle, physicians are reluctant to allow people who have had a heart attack to continue drinking.

In addition, "these observed benefits have to be viewed in light of the clear hazards of heavy alcohol consumption in the general population," adds co-author Charles H. Hennekens, M.D., professor of medicine at Harvard Medical School and chief of the division of preventive medicine at Brigham and Women's Hospital. "In the United States, heavy alcohol consumption is a leading cause of avoidable deaths."

Light to moderate drinking reduces the risk of heart attack and premature death in healthy individuals, several previous reports have shown. The study reported today, however, examines the effect of drinking alcohol in people who have had a heart attack.

The study included 4,797 male physicians who had suffered a previous heart attack and 953 who had experienced a stroke. Men who drank one or two alcoholic drinks reduced their risk of premature death and the risk of a fatal heart attack by 20 to 30 percent.

The men in the study were among more than 90,000 doctors who filled out a questionnaire to enter the Physicians' Health Study, a trial designed in part to learn if low doses of aspirin reduce the risk of a first heart attack. The physicians in Gaziano's study were rejected for the aspirin trial because of their previous heart and stroke problems.

The physicians provided extensive information regarding their medical histories, health risk factors and behavior patterns, including their drinking habits. Alcohol consumption was divided into seven categories, ranging from "never," "rarely" to "two or more drinks per day."

Gaziano and his colleagues found that 982 of the 4,797 physicians who had suffered a previous heart attack had died in the six years from 1984 through 1989.

The team obtained copies of the death certificates and classified the deaths from either a heart attack, caused by a loss of oxygen-carrying blood to the heart muscle because of a blood clot or narrowing of an artery, or from cardiovascular disease (CVD) in general (a heart attack, stroke, or sudden-death heart attack, which may be caused by an irregular heart beat).

Among those with a prior heart attack, heart attack caused 282 deaths; 715 deaths resulted from cardiovascular disease including heart attack; and other causes accounted for 167 deaths. Similar death rates of cardiovascular disease were found among the 953 physicians who had previously suffered a stroke: 59 heart attack, 176 CVD, and 263 total deaths.

The researchers compared the causes of death and the physicians' alcohol intake, as they had reported it on their questionnaire. Most of the physicians who drank were light to moderate drinkers in the range of a few drinks per month to less than two drinks per day. Among those with previous heart attack, those who drank two to four drinks per week up to and including two or more drinks per day, had a 20 to 30 percent lower risk of heart attack, cardiovascular disease and total death. Similar trends were apparent for those who had previous strokes.

Because few of the physicians in the study drank more than two drinks a day, the researchers point out that the findings do not answer the question of whether that much confers any benefits or risks.

All physicians should discuss alcohol intake with their patients first and identify and counsel problem drinkers. However, for patients with previous heart attack or stroke who are light to moderate drinkers, this behavior appears to be safe and may confer modest benefits, says Gaziano.

Other co-authors of the report are Robert J. Glynn, Ph.D. and Julie E. Buring, Sc.D.
-end-


American Heart Association

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