Moderate drinking associated with lower risk of heart disease
22 August 2018
Unstable drinking patterns may be associated with a higher risk of heart disease and consistent moderate drinking may have a cardioprotective effect, according to research led by UCL.

In this meta-analysis study, published in BMC Medicine, researchers from UCL and the University of Cambridge examined longitudinal data on 35,132 individuals.
The study found that compared to individuals who consistently followed UK sensible drinking guidelines over a period of ten years, those who inconsistently drank in moderation, those who had stopped drinking (former drinkers) and those who reported no drinking had a higher risk of coronary heart disease (CHD), although the effect observed in non-drinkers may be confined to women.
Dr Dara O'Neill (UCL
Institute of Education) who led the research said, "This study uses
long-term data to distinguish between persistent non-drinkers and former drinkers,
allowing us to test the established theory that only the latter have an
elevated risk of CHD. We did not find this to be the case but we did observe a
sex-related difference. Amongst consistent non-drinkers, women showed higher
risk of developing CHD compared to consistently moderate drinkers, but their
male counterparts did not."
Overall, 1,718 (4.9%) out of the 35,132 individuals included in the six cohorts
that were examined in this study developed CHD during the study period, of
which 325 (0.9%) were fatal CHD events. Observed CHD incidence was highest for
former drinkers, 6.1% of whom experienced a CHD event of which 1.2% were fatal,
and lowest for consistently heavy drinkers, 3.8% of whom experienced a CHD
event of which 0.6% were fatal. The authors caution that there is considerable
doubt around the estimates of CHD risk in heavy drinkers due to an
under-representation of heavy drinkers in the study sample, especially among
women.
Dr O'Neill said, "Given that heavy drinkers are known to be under sampled in
population level surveys, interpretation of the absence of effect amongst heavy
drinkers in the current study should be done very cautiously, particularly in
light of the known wider health impact of heavy alcohol intake levels."
The findings suggest that instability in drinking behavior over time is
associated with CHD risk. This may be because unstable drinking patterns
reflect wider lifestyle changes across the course of people's lives, including
periods of ill-
health or life stress, according to the authors. Lifestyle changes may also
account for variations in risk the authors observed when they compared
different age groups.
Dr O'Neill added, "When we split the sample by age, we found that the elevated
risk of incident CHD amongst inconsistently moderate drinkers was observed in
participants aged over 55, but not those aged below. It may be that the older
group experienced lifestyle changes, such as retirement, which are known to co-
occur with increases in alcohol intake and that these could have played a role
in the differing risk."
In order to examine associations between CHD and drinking behavior over time,
the authors analysed prospectively collected, longitudinal data on
self-reported weekly alcohol consumption from six studies - five from the UK
and one French study - which included information on alcohol intake over a
period of ten years, together with information on CHD events.
Drinking behavior over time was assessed by measuring intake based on the
alcohol content in reported drinks; half pints of beer or cider, small glasses
of wine and a single serving of spirits were recorded as containing 8g of
ethanol in the UK cohorts and 10g of ethanol in the French cohort. Moderate
drinking was considered to be up to 168g/ethanol per week for men and up to
112g ethanol/week for women.
The authors note that a lack of information on alcohol intake prior to the
beginning of the 10-year assessment period could mean that the long-term
abstainers identified in this study include some former drinkers. Sick heavy
drinkers may also not have been captured in the study sample due to possible
dropout from the investigation at an earlier stage. The observational nature of
the individual studies included in this analysis does not allow for conclusions
to be drawn about cause and effect.
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Rowan Walker
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Email: rowan.walker [at] ucl.ac.uk