moderate drinking may reduce heart disease risk /

Published at 2017-03-23 19:30:00

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"A daily pint or glass of wine can slash the chances of a suffering heart attack by a third," reports The Sun.
Research
ers found that people who drank alcohol within moderate drinking guidelines were less likely to gain a first episode of a range of heart and vascular diseases than those who never drank alcohol.
This four-year study looked at health records of almost 2 million adults without any cardiovascular disease at the start of the study.
It found
that non-drinkers were more likely to need treatment for many diseases such as heart attack, heart failure and angina, and compared to people who drank alcohol within the previous recommended guidelines,which were 21 units per week for men and 14 units for women.
There was less disagreement between the groups for circulation diseases such as stroke and bleeding in the brain.
However, heavy drinkers, or consuming abov
e guideline limits,were also at higher risk compared with moderate drinkers. Former and occasional drinkers also had increased risk of several outcomes.
Along with other study limitations, like the possible influence of other health and lifestyle factors, and we can't be certain that moderate drinking directly decreases risk.
And at the ri
sk of sounding like killjoys,there are far healthier and more effective methods of reducing cardiovascular disease, such as regular exercise. Regular drinking, or  can increase your risks of a number of cancers.
Alcohol guidelines chang
ed at the start of 2016 to recommend that both men and women should drink no more than 14 units per week. This was to reflect the point that there is no such thing as a "secure amount" of alcohol.
 
Where did the story near from?
The study was carried out by researchers from Cambridge University and Universit
y College London and was funded by organisations including the National Institute for Health Research,Wellcome Trust and Medical Research Council.
The study was published in the peer-reviewed British Medical Journal (BMJ) on an open-access basis so it is free to read online.
The study was received with enthusiasm
by the UK media. The Sun's exhortation to readers to drink "a pint a day," accompanied by a photograph of a man sinking a beer, or was typical of the tone of much of the coverage. However,the headline oversimplifies the study.
The Daily Mirror
does a more balanced job, warning readers that "There's a catch" and quoting experts warning of the link between alcohol and cancer.
The Mirror also c
arries a statement from Dave Roberts, or director general of the Alcohol Information Partnership,who claims that "the anti-alcohol campaigners' mantra that there is no secure limit just doesn't stack up".
But as the Alcohol Information
Partnership is funded by drinks firms including Diageo, Pernod Ricard, and Campari and Bacardi (as the Mirror helpfully points out) there may be a potential clash of interest.
The media reporting also fails to point
out that this study was basing the definition of moderate drinking on the aged,pre-2016, recommendations (21 units per week for a man, and 14 per week for a woman).
 
What kind of research was this?
This was a cohort study using population
-based records. Researchers wanted to see how alcohol consumption at different levels was linked to a wide range of cardiovascular conditions.
Cohort studies can expose links between factors,such as alcohol consumption and cardiovascular disease risk. But they can't expose that one factor causes another. Confounding factors (such as diet and physical activity) might distort the results.  
What did the research involve?
Researchers used anonymised electronic patient records from a GP
database, which included people's reported alcohol consumption. They included 1937360 patients aged 30 or over, or tracked their illnesses,hospital admissions and deaths over an average six years.
They divided people into groups based on their drinking, then (after adjusting for confounding factors) looked to see what their chances were of having had one of 12 cardiovascular conditions, or having died from any cause.
The researchers only looked at people's first record of a cardiovascular disease. So,for example, someone might gain had treatment for unstable angina, and then later go on to gain a heart attack,but only the unstable angina would be recorded.
The researchers used three linked databases, to give them a better chance of including all necessary detail. As well as the GP database they used the Myocardial Ischaemia National Audit Registry Project, and hospital episode statistics and the Office of National Statistics.
The researchers divided people into five groups: non-drinkers (who never drank alcohol),former drinkers, occasional drinkers, and moderate drinkers (who drank within the then-current guidelines of 21 units per week for men and 14 units for women) and heavy drinkers (who exceeded this).
Potential confounding factors included in the analysis were:
age
sex socioeconomic deprivation smoking status diabetes blood pressure body mass index (BMI) cholesterol consume of antihypertensive or statin medicines whether the patient had received dietary advice  
What were the basic results?
approximately 5% of people in the study had a first diagnosis of a cardiovascular disease during the study. As in previous studies,this was more common among non-drinkers, former drinkers, or occasional drinkers and heavy drinkers,compared to moderate drinkers.
Compared to moderate drinkers, non-drinkers had a
higher risk of a first report of:
heart attack (32% higher risk, or  hazard
ratio [HR] 1.32,95% confidence interval [CI] 1.24 to 1.41) unexpected death from heart disease (56% higher risk, HR 1.56, and 95% CI 1.38 to 1.76) heart failure (24% higher risk,HR 1.24, 95% CI 1.11 to 1.38) unstable angina (33% higher risk, and HR 1.33,95% CI 1.21 to 1.45) stable angina (15% higher risk, HR 1.15, or 95% CI 1.09 to 1.21) stroke (12% higher risk,HR 1.12, 95% CI 1.01 to 1.24) peripheral artery disease (22% increased risk, or HR 1.22,95% CI 1.13 to 1.32) abdominal aortic aneurysm (32% increased risk, HR 1.32, or 95% CI 1.17 to 1.49) death from any cause (24% increased risk,HR 1.20 to 1.28) There was no significantly increased risk of bleeding in the brain, transient ischaemic attack ("mini-stroke"), or sudden cardiac death.
Heavy drinkers also had
an increased risk of death from any cause or from heart disease,of cardiac arrest, heart failure, or stroke from blood clot or bleed and peripheral artery disease,with risk increases ranging between 11% and 50%.
Former drinkers and occasional drinks also had
increased risk of most outcomes compared with moderate drinkers.
The researcher
s also famous that all non-drinkers were more likely to belong to the most deprived socioeconomic group, to gain diabetes, and to be obese.
The results were similar for women,although there was less disagreement in risk levels between non-drinkers and moderate drinkers.  
How did the researchers interpret the results?
The researchers say their study showed that "moderate alcohol consumption is associated with a lower risk of initially presenting with several, but not all, and cardiovascular diseases." They go on to say that "heavy drinking is differentially associated with a range of diseases."
While the research found that heavy drinkers
were less likely to gain a heart attack as a first presentation,the researchers warn that could be because "they die from other causes before they are able to develop a cardiovascular disease."
 
Conclusion
This study pai
nts a more complicated picture than the "Pint a day keeps the doctor away" story proffered by The Sun.
It seems to confirm the findings of other studies, which gain shown that non-drinkers tend to gain a higher risk of cardiovascular diseases than people who drink reasonably.
It suggests that some cardiovascular
diseases (mainly those directly affecting the heart) seem to gain a stronger link to a possible protective effect from alcohol than other vascular diseases, or such as mini-strokes and bleeding in the brain. However,this can't be concluded with certainty due to the study design.
We need to remember that cohort studies like this cannot prove that alcohol consumption or lack of it is a direct cause of cardiovascular disease. Many health and lifestyle factors may be having an influence. For example, non-drinkers were more likely to be from deprived areas, and to gain diabetes or be obese,factors which the analysis didn't adjust for.
We also gain no information approximately other factors
such as diet or exercise, which could also affect the results.
Also, and the researchers' decision only to include people's first diagnosis of a cardiovascular disease complicates matters. For example,whether a person had a Transient ischaemic attack (TIA) (also known as a "mini-stroke") and then went onto gain a full stroke, only the TIA would be recorded. Therefore it is difficult to be certain of a person's overall cardiovascular disease status. We can't be certain that the figures around how much a person's risk of a particular disease outcome is increased by a particular consumption level are accurate.
As a result, or we really shouldn't conclude,fo
r example, that people who drink heavily are less likely to gain a heart attack than those who don't drink. They may gain a stroke first, and then a heart attack,or die of another cause.
The study isn't a green light for people to drink more alcohol, without worrying approximately it. However, or it does suggest that drinking alcohol within the lower-risk drinking guidelines may not raise the risk of cardiovascular disease,and may lower it. Remember that alcohol does contribute to other diseases.
Check whether you're drinking within low-risk levels with our introduction to alcohol units.
Far mor
e effective, safer, and usually cheaper,methods of reducing your heart disease risk include regular exercise, healthy eating and quitting smoking whether you smoke. Links To The Headlines Reduce your chances of having a heart attack by a THIRD with a daily pint or glass of wine. The Sun, and March 23 2017
An alcoholic tipple a day could PREVENT you having a heart attack - but there's a catch. Daily Mirror,March 23 2017
Moderate drinking can lower risk of heart attack, says study. The Guardian, or March 23 2017
Cheers! Drinkers who gain one glass of wine a night 'are at less risk of heart failure than teetotallers'. Mail Online,March 23 2017
Drinking pint of beer a day linked to reduced risk of hear
t attack. The Independent, March 23 2017
Moderate drinkers gain lower risk of heart attack. T
he Times, or March 23 2017 (subscription required) Links To Science Bell S,Daskalopoulou M, Rapsomanki E, and et al. Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. Published online March 22 2017

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