Many myths surround the consumption of alcohol, its effects on the heart and the question ‘can alcohol make you live longer?’. One myth proposes that if some alcohol is good for the heart, more must be better. Another myth contends that the best way to protect the heart is to avoid alcohol altogether. Like all good myths, though, these ideas cloak a kernel of truth in a cover of wishful thinking. The ancient Greeks, makers of fine myths themselves, had their own ways to explain alcohol and human behavior. One such story is of Dionysus, son of Zeus himself, who grew up to be the god of the grape harvest and the god of wine. While few worship alcohol in twenty-first century, the mythological effects of alcohol’s impact warrant further review. Like most myths, the truth lies somewhere in the middle.
In a landmark article published in 1997, investigators looked at the self-reported alcohol intake in almost a half-million Americans to determine if an optimal amount of alcohol intake existed. Following these patients for almost ten years, the investigators compared those who abstained from alcohol to those who reported one drink a day (the equivalent to a 12-ounce beer or a 5-ounce glass of wine). The results were surprising. Those who had one drink a day actually had a lower mortality compared to their tee-totaling peers. This research reinforced the outcomes of earlier studies. In analyzing the results, the investigators proposed that the reason for the improved mortality in modest alcohol consumption was due to improved cardiovascular outcomes, especially for those already at high-risk for cardiovascular disease.
On the day the study was published, The New York Times quoted a Harvard public health official as seeing a “whopping big effect.” What was less likely to make the headlines from that study, though, was the risk of drinking too much alcohol. Buried in the back pages of the report, investigators demonstrated that too much alcohol consumption (more than two drinks a day) caused increased death from many unpleasant causes: cancers of the mouth, throat and liver, along with cirrhosis. With such potentially beneficial news from a potentially harmful substance, how were health officials to respond?
As it turns out, investigators responded with education and more research. Physicians could now educate their patients to the benefits of modest alcohol intake while investigators helped answer the question of why it worked. Looking at a group of high-risk patients with known heart disease, medical scientists considered the effect of modest alcohol consumption on those most likely to have another heart attack. When their study was finally published in 2010, the investigators confirmed that among the more than 16,000 patients, consuming 1 to 2 drinks a day showed not only a reduction in the risk for future heart events but also a reduction in death. Other studies speculated that the cause for such benefit was due to increased HDL (the good cholesterol) and decreased stickiness of platelets that can cause clots in the coronary arteries.
Doctors resurrected the myth of Goldilocks in counseling their patients about alcohol consumption: not too much but not too little.
Much of the recent research debunking the myths of alcohol and the heart only add to a body of clinical data that has long been known. German pathologists in 1884 reported cases of “Munich Beer Heart,’ which came to be known in the twentieth century as alcoholic cardiomyopathy, the end result of long periods of excessive alcohol intake. Twenty-first century scientists dug deeper into this condition, discovering that chronic, excessive alcohol use—defined as three or more drinks a day—increased blood pressure, increased LDL (the bad cholesterol) and increased the risk of cardiomyopathy. But the heart cannot hide from periodic excessive use, either. Holiday Heart, another catchy name for a critical condition, is an arrhythmia that occurs after intermittent binge drinking of alcohol.
As if all of this historical data were not enough to make heavy drinkers weak in the knees, recent data published this year indicates that three or more drinks a day are associated with early onset dementia compared to those who modestly imbibe 1 to 2 drinks daily.
It has taken researchers years to debunk, and then explain, the myths of alcohol and the heart. Such a time frame of epic proportions seems to be the stuff of classical mythology. Homer, a Greek story teller who penned the epic tale of The Odyssey, described in one section of his poem the sweet songs of the Sirens who lured sailors to their rocky shores. Only the most experienced seamen could navigate the dangerous straights by focusing on their destination and not succumbing to the mythological allure. So it is with the mellifluous music that alcohol hums to the heart. By focusing on the outcomes of health and longevity and not getting sidetracked on the rocky shores of excess, patients can raise a glass to toast the benefits of modest alcohol intake knowing that history, and evidence, is on their side.