Is the cardio-protective action of alcohol a myth?

The idea that moderate drinking is ‘good for the heart’ has become deeply entrenched. However, a new French study lends further support to the idea that the allegedly protective effect of alcohol on the cardiovascular system may be more appearance than reality. While it is not disputed that in many, particularly Western, populations, middle aged and elderly people who drink moderately have a lower risk of dying from heart disease than either total abstainers or heavy drinkers, the new study adds weight to the view that the real explanation of this pattern is not that alcohol is protective, but simply that the average health status of people who drink low or moderate amounts of alcohol is better than that of tee-totalers.

In the study, published in the European Journal of Clinical Nutrition, Boris Hansel and colleagues studied 149,773 people from the Urban Paris- Ile-de-France Cohort and split them into four groups; never, low, moderate and high alcohol intake. The low and moderate groups of both males and females displayed a more favourable health status than the groups that never drank or drank large amounts. Moderate male drinkers were more likely to have lower cardiovascular risk, heart rate, stress, depression and body mass index. They also scored higher with subjective health measures such as respiratory function and physical activity. Similar trends were seen in moderate female drinkers who had lower blood pressure and waist circumference. Importantly, the findings showed moderate alcohol consumption is a powerful general indicator of optimal social status and this could be a key reason for improved health in these subjects. For both genders, alcohol intake was strongly associated with increased concentrations of High Density Lipoprotein (HDL) in the blood plasma. However, it could not be shown that the influence of alcohol on HDL had a cardio-protective effect and the authors stress these results cannot be taken as evidence of alcohol providing cardiovascular protection.

European Journal of Clinical Nutrition 64, 561-568 (June 2010) doi:10.1038/ejcn.2010.61 Relationship between alcohol intake, health and social status and cardiovascular risk factors in the urban Paris-Ile-De-France Cohort: is the cardioprotective action of alcohol a myth?

B Hansel, F Thomas, B Pannier, K Bean, A Kontush, M J Chapman, L Guize and E Bruckert