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Alcohol and Health - Alcohol the heart
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What the Doctor says
Cardiovascular disease (CVD) is the main cause of death in the UK . It was responsible for 38% of all deaths.In 2003 when 233,000 people died from CVD in the UK .About half of all deaths from CVD in the UK are from coronary heart disease (CHD) and about a quarter are from stroke.

In 2003, CHD caused just under 114,000 deaths a year in the UK : approximately one in five deaths in men and one in six deaths in women. This compares to around 33,000 deaths a year from lung cancer, 16,000 deaths from colo-rectal cancer and 13,000 deaths from breast cancer. (all statisics from www.heartstats.org).

Please visit www.alcoholinmoderation.com for specific studies regarding alcohol and the heart and references.

How does alcohol protect my heart?

Alcohol, 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.

Red wine, dark beer and traditional ciders also contain phenolic compounds. Phenolic compounds also inhibit excessive coagulation and enhance the relaxation of blood vessel walls, allowing better blood flow. Although the phenolic compounds are shown to be antioxidants in the test tube, it is uncertain whether they inhibit the oxidation of LDL cholesterol in animals and humans, and hence prevent the build up of cholesterol in arteries, which is referred to as hardening of the arteries.

Regular moderate alcohol consumption reduces the risk of coronary heart disease and stroke mainly in men aged over 40 years and in post-menopausal women, when the risk factors for coronary heart disease and stroke significantly increase.Drinking alcohol is not recommended if you have uncontrolled, high blood pressure. If someone has an existing heart condition, alcohol can generally be drunk in moderation, but only if alcohol use does not affect the medication, a doctor’s advice should be sought. 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 standard drinks per drinking session, is seen to significantly increase systolic blood pressure, which significantly increases the risk of coronary heart disease or stroke (Hillbom and Kaste 1981, Kozarevic et al. 1983, Hillbom et al. 1984, Donahue et al. 1986, Suhonen et al. 1987, Renaud and Ruf 1996).
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 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.

For in-depth information, please visit the AIM-Gateway site at www.aim-digest.com/gateway/

LINKS

British Heart Foundation www.bhf.org.uk
Department of Health www.doh.gov.uk

REFERENCES

Alcohol and the heart
Red wine procyanidins and vascular health. Nature 2006; 444: 566. Corder R, Mullen W, Khan NQ, et al.
Alcohol and Cardiovascular Diseases:A Historical Review and 2005 Update Arthur L. Klatsky, MD Senior Consultant in Cardiology, Kaiser Permanente Medical Care Program, Oakland, California, USA
Wine, alcohol and cardiovascular risk: an epidemiological perspective G. de Gaetano, A. Di Castelnuovo et al. Iacoviello Research Laboratories, John Paul II Centre for High Technology Research and Education in Biomedical Sciences, Catholic University, 86100 Campobasso, Italy
Alcohol consumption and risk of heart failure in the Physicians’ Health Study I. Circulation. 2007;115(1):34–39. Djoussé L, Gaziano JM.
The Epidemiologic Evidence for the Cardioprotective Effects Associated with the Consumption of Alcoholic Beverages, Pathophysiology. 2004 Apr; 10(2): 83-92. M. Gronbaek

Stroke
Alcohol consumption and risk for stroke among Chinese men. Annals of Neurology, published online 20 Aug 2007; doi: 10.1002/ana.21194. Bazzano, L.A., et al.
Lowering cholesterol lowers women’s stroke risk Neurology Feb. 20, 2007. T Kurth, M Fink.
Moderate Alcohol Consumption Reduces Risk of Ischemic Stroke: The Northern Manhattan Study. Stroke 2006;37:13-9. Elkind MSV et al.
Prevention of first stroke - a review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. Journal of the American Medical Association: 1999:281:12. Gorelick P et al.