What amount-and type-of alcohol is most effective in lowering cardiovascular risk? A recent paper suggests that drinking wine responsibly reduces the risk of heart disease to a greater extent than moderate consumption of beer or spirits, such as whiskey.
What amount-and type-of alcohol is most effective in lowering cardiovascular risk? A recent paper suggests that drinking wine responsibly reduces the risk of heart disease to a greater extent than moderate consumption of beer or spirits, such as whiskey. Although the journal reporting the study, Angiology, is not typically read by nonspecialists, your patients-particularly wine aficionados-may already be aware of the results.
BENEFITS OF MODERATE DRINKING
Athyros and colleagues1 attempted to define alcohol's effect, based on the amount imbibed, on the risk of several diseases, including metabolic syndrome, type 2 diabetes mellitus, coronary artery disease, stroke, peripheral arterial disease, and overall cardiovascular disease. Participants in the study were classified as nondrinkers (lifetime abstainers and former drinkers), occasional drinkers (drinking on a monthly basis), mild (1 to 19 g of ethanol per day), moderate (20 to 45 g/d), and heavy (more than 45 g/d) drinkers. Binge drinkers were classified as heavy. In the cohort, 706 (17%) were nondrinkers, 955 (23%) occasional, 1121 (27%) mild, 997 (24%) moderate, and 374 (9%) heavy drinkers. Among the drinkers, 1000 were wine drinkers, 1241 favored beer, and 1206 drank predominantly spirits.
Among those who drank moderately, there was a lower trend in the prevalence of metabolic syndrome, diabetes, coronary disease, peripheral vascular disease, and overall cardiovascular disease, but not of stroke (the risk of stroke was lower in those who did not drink alcohol). In contrast, heavy drinking increased the risk of all the diseases studied.
Wine consumption was associated with a slightly lower overall risk of cardiovascular disease than beer or spirit ingestion. Beer, in turn, was more effective in lowering risk than spirits.
A CAUTION TO IMBIBERS
A summary of an interview with Dr Dimitri Mikhailidis, one of the study's authors, is available at www.winespectator.com.2 Dr Mikhailidis pointed out potential weaknesses in the study (it was performed against a background of a protective Mediterranean diet in Greece) and noted that the results should encourage heavy drinkers to decrease their intake of alcoholic beverages.
Another study shortcoming was that the drinking pattern (ie, occasional, moderate, or heavy) was self-defined by a questionnaire. But despite its weaknesses, this study appears to confirm much of the earlier literature that attests to the salutary effects of moderate wine consumption. For those who think that these benefits are a ticket to increased drinking, this Top Paper also provides a serious caution. Although a little may be good for you, a lot surely is not.
1. Athyros VG, Liberopoulos EN, Mikhailidis DP, et al. Association of drinking pattern and alcohol beverage type with the prevalence of metabolic syndrome, diabetes, coronary heart disease, stroke, and peripheral arterial disease in a Mediterranean cohort. Angiology. 2007;58:689-697.
2. Gaffney J. Moderate drinkers less likely to develop deadly diseases, study finds. Wine Spectator Online. Published February 29, 2008.
. Accessed May 9, 2008.