The Impact of Alcohol Consumption on Cardiovascular Health: Myths and Measures

This relationship and its implications remain controversial due to a lack of long-term randomized controlled trials with CVD endpoints. Oftentimes, whether or not a J-curve or an inverse or U-shaped relationship is observed depends on the range of alcohol consumption reported in an individual study and the specific IHD endpoint considered (fatal or non-fatal). Does some alcohol consumption protect some people against ischaemic diseases to some degree? Epidemiological data, as outlined in this review, suggest that this is the case (Table 1). For example, a J-shaped relationship emerges for average alcohol consumption and IHD and IS.

More contemporary studies have not found evidence of mitochondrial injury in aa types of meetings biopsy samples from long-term alcohol drinkers (Miró et al. 2000). Differences among results from human studies may relate to small sample sizes, duration of drinking, and degree of myocardial dysfunction. In the Miró study, alcohol drinkers also had been receiving pharmacologic treatments such as beta-adrenergic blocking agents that reduce blood pressure and also may have antioxidant effects. As noted in the text, the exact amount and duration of alcohol consumption that results in ACM in human beings varies. Data from animal models and human beings with a history of long-term drinking suggest that oxidative stress may be an early and initiating mechanism. Many cellular events, such as intrinsic myocyte dysfunction, characterized by changes in calcium homeostasis and regulation and decreased myofilament sensitivity, can come about due to oxidative stress.

More recently, Cosmi and colleagues (2015) examined the effects of daily wine consumption in subjects enrolled in an Italian trial of heart failure patients (mean age ~67), most of whom had reduced ejection-fraction heart failure. Different levels of daily wine consumption (i.e., sometimes, 1 to 2 glasses/day, and ≥3 glasses/day) had no effect on fatal or nonfatal outcomes (e.g., hospitalization for a CV event). Subjects who drank wine more often, however, were less likely to have symptoms of depression and more likely to have a better perception of health status. They also had lower levels of circulating inflammatory markers, such as C-terminal proendothelin-1 and pentraxin-3 (Cosmi et al. 2015). Several reports indicate that alcohol first exerts a seemingly positive effect, followed by a more negative impact (i.e., it is biphasic) on the endothelial–nitric oxide–generating system.

Hypertension treatment guidelines

1. Having a glass of wine with dinner or a beer at a party here and there isn’t going to destroy your gut.
2. Conflicting associations depending on the exposure measurement and CVD outcome are hard to reconcile, and make clinical and public health recommendations difficult.
3. Mean systolic and diastolic BPs for White, Black or Asian men and women for known drinking habits (adopted from Klatsky et al.54 with permission).

Furthermore, when compared by income groups, a higher overall burden of death was observed in lower and middle income countries compared to high-income countries 1. Heavy drinking can also lead to a host of health concerns, like brain damage, heart disease, cirrhosis of the liver and even certain kinds of cancer. In a systematic review, McFadden et al.79 analyzed clinical trials that examined the BP after a period of sustained alcohol intake. In this review, the pressor effect of alcohol was evident in non-ABPM studies, but not in ABPM studies. An early effect of reducing the BP and a later effect of raising the BP led to smaller differences in the net effect of alcohol on BP values in ABPM studies. Experimental studies have shown that alcohol suppresses the baroreceptor reflex.43 Narkiewicz et al.44 reported that alcohol enhances the hypotension induced by lower body negative pressure.

Many studies have found that the combination of high HDL and low LDL levels protects against heart attacks and stroke. “However, this is not the most important factor in preventing heart disease, and there are other ways to increase HDL than drinking alcohol, such as regular exercise,” says Dr. Gaziano. The J-shaped risk relationship has been found in both sexes and for IHD morbidity and mortality 16,21. In a meta-analysis comprising 957,684 participants and 38,627 events, a J-shaped curve in relation to lifetime abstainers was observed in women for both fatal and non-fatal IHD outcomes, and an inverse relationship was observed in men with non-fatal IHD events 16.

It’s possible that light to moderate drinkers have stronger social ties, which in turn provide resilience against stress. The study authors are now focusing on other interventions — such as meditation or exercise — that might lower the brain’s stress activity without the potentially harmful effects of alcohol. The acute effects of alcohol on the myocardium include a weakening of the heart’s ability to contract (negative inotropic effect). Data from isolated papillary and heart muscle cell (myocyte) experiments demonstrate that acute physiologic intoxicating doses of alcohol (80 mg% to 250 mg%) can have a negative inotropic effect (Danziger et al. 1991; Guarnieri and Lakatta 1990).

Factors that may Explain the Conflicting Findings between Alcohol Intake and body Weight

These usually come with a warning sticker from your pharmacy that tells you not to drink while you take them. One drink is 12 ounces of beer or wine cooler, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.

It has been shown that low doses of alcohol increase the release of nitric oxide and augment endothelium-dependent vasodilation.32 Criscione et al.27 reported that ethanol inhibits norepinephrine-induced vasoconstriction in the rat mesenteric artery. They also observed that norepinephrine-induced vasoconstriction is enhanced after the withdrawal of alcohol. These results seem to be consistent with the time-dependent BP changes after alcohol consumption in humans. Drinking alcohol to excess can cause other serious health conditions, such as cardiomyopathy (where the heart muscle is damaged and can’t work as efficiently as it used to) and arrhythmias (abnormal heart rhythms).

Some research noted that endothelial function is impaired in abstinent individuals with a long-term history of alcohol abuse or alcoholism(Di Gennaro et al. 2007, 2012; Maiorano et al. 1999). Future studies would benefit from using direct biomarkers of alcohol consumption, such as phosphatidylethanol (PEth), to corroborate self-report of alcohol consumption and distinguish among low, moderate, and heavy alcohol consumption (Kechagias et al. 2015; Piano et al. 2015). A review by Yeomans 5 highlights some of the potential explanations for alcohol’s influence on weight gain or obesity. First, as previously mentioned, energy from alcohol appears to be additive to energy from other sources 5. Several studies suggest that consuming alcohol before or during a meal does not influence the amount of food eaten in that meal, despite increasing the energy density of the meal 5. Thus, individuals do not appear to compensate for the added energy from alcohol in the short-term, and alcohol appears to have little effect on satiety 5.

Are there benefits to drinking alcohol?

According to 2022 research, any amount of alcohol can have a negative impact on the heart and cardiovascular system. The Dietary Guidelines for Americans recommends that people avoid drinking when possible. However, if someone wants to drink, it is best to stay within the recommended limits. It is important to note that there is no causal link to suggest that drinking, even moderately, contributes to better heart health.

The higher the alcohol consumption within 24 h or one week, the higher the risk for IS or HS 53,80. In various biologic systems, oxidative stress can be measured or inferred by several biologic indexes. The way in which alcohol consumption has been measured and categorized varies, sometimes making it challenging to compare data among studies.