Know the Risks & Benefits
Before you raise your glass, you should be aware of some important ways
that alcohol affects your heart. For example, did you know that:
in the hour after alcohol consumption, a person’s risk of stroke and
heart attack doubles?
potentially dangerous arrhythmias can result from too much holiday
cheer, a condition that has come to be known as Holiday Heart Syndrome?
moderate alcohol consumption on most days of the week may help guard
against heart disease?
These are some of the key discoveries that have emerged from the
Cardiovascular Epidemiology Research Unit
(CVERU) at Beth Israel Deaconess Medical Center (BIDMC). In conjunction
with the Harvard T.H. Chan School of Public Health (HSPH), the CVERU
conducts observational and experimental research to identify risk factors
for heart disease. Under the direction of
Murray Mittleman, MD, DrPH
, the CVERU is nationally recognized for its many studies examining how
alcohol consumption impacts cardiac health.
“Whether alcohol protects us from heart disease or promotes heart disease
depends on a number of key factors,” says Mittleman (right), who is also a
preventive cardiologist in BIDMC's
Professor of Epidemiology
at HSPH. “These include the amount of alcohol consumed and the frequency of
Either way, the take-home message is the same: If you do drink, do so in
moderation. That means no more than one drink per day for women and no more
than two drinks per day for men, according to guidelines from the American
Heart Association. A drink is defined as 12 ounces of beer, four ounces of
wine, 1.5 ounces of 80-proof spirits, or one ounce of 100-proof spirits.
Five facts to keep you healthy through the holidays:
1. The Not-So-Happy Hour
A large study by BIDMC researchers
published earlier this year reported that in the hour following alcohol
consumption, a person’s risk of having a stroke or heart attack actually
doubles. Led by
Elizabeth Mostofsky, ScD, MPH, a scientist in BIDMC’s CVERU, the comprehensive meta-analysis (a study of
studies) analyzed data from 23 studies conducted between 1966 and 2015,
involving a total of 30,000 participants. The goal was to better understand
a person’s risk of having a stroke or heart attack in the hours and days
after consuming alcohol.
“It’s a complicated subject,” says Mostofsky (right), who is also an
instructor at HSPH. “The fact is that alcohol has complex physiological
effects that can result in both higher cardiovascular risk and lower
cardiovascular risk. We found that any alcohol consumption raised a
person’s risk of a heart attack or stroke approximately two-fold within the
hour following consumption compared to other times. After 24 hours, though,
only heavy alcohol intake conferred a continued heightened risk. “
Immediately following alcohol intake, heart rate increases, blood pressure
rises and blood platelets become stickier. This may increase the risk of
heart attack and stroke. But over time, regularly drinking small amounts of
alcohol appears to lower cardiovascular risk by increasing levels of
high-density lipoprotein (HDL) cholesterol, the so-called “good
cholesterol,” while also reducing a person’s tendency to form blood clots.
“Based on our results, it is possible that the brief risks we see right
after drinking alcohol are outweighed by the health benefits of regularly
drinking modest amounts of alcohol,” says Mostofsky.
2. Holiday Heart Syndrome
You may associate the term “binge drinking” with a college fraternity
party, but it actually refers to any episode of excessive drinking. This is
defined by the U.S. Office of Disease Prevention and Health Promotion’s
2015 Dietary Guidelines as 15 drinks or more per week for men and eight
drinks or more per week for women.
Around the holidays, one of the greatest risks develops when people who
don’t usually drink at all find themselves celebrating at parties or “binge
drinking” while on vacation, a problem that was first identified almost 40
years ago and is now often referred to as “
holiday heart syndrome.”
of both men and women of an average age 50, found that heavy drinking — 35
or more drinks per week — led to a 45 percent increase in men’s risk of
developing atrial fibrillation, a dangerous type of arrhythmia and a
leading risk factor for stroke.
In cases of atrial fibrillation, the heart’s upper (atrial) chambers do not
adequately contract, creating a situation in which blood can collect and
clot. If a blood clot travels to the brain, it can cause a stroke.
According to the American Heart Association, atrial fibrillation is
responsible for approximately 15 to 20 percent of all strokes.
In the BIDMC study,
the researchers found
that the risk of developing atrial fibrillation begins to increase at about
four drinks per day, and clearly goes up at five drinks a day.
“This would seem to confirm what has long been suspected regarding periods
of heavier-than-normal alcohol consumption, such as over the holidays or
during vacations,” says Mittleman.
“Consuming large amounts of alcohol at once may result in both a sharply
higher immediate risk and a higher long-term risk, but habitual moderate
alcohol consumption has been shown to lower the risk of heart attacks and
strokes,” adds Mostofsky.
3. A Drink a Day May Keep Heart Disease at Bay
What you drink — beer, wine or spirits — isn’t nearly as important as how
frequently you drink.
study by researchers at BIDMC and HSPH
published in The New England Journal of Medicine tracked the
drinking habits of nearly 40,000 men over a 12-year period and showed that
men who drank moderate amounts of alcoholic beverages three or four times a
week had a 30 to 35 percent reduced risk of heart attack compared with
The study showed that having seven drinks on a single occasion and then not
drinking the rest of the week isn’t the equivalent of having one drink a
day: The weekly total may be the same, but the health implications are
Furthermore, among men between the ages of 40 and 75, moderate drinking —
no more than two drinks a day — may be better for heart health than not
drinking at all.
These findings are in keeping with
“In our study on the acute effects of alcohol on the risk of heart attacks,
we found that among participants who did not drink alcohol daily, there was
a 3.3-fold higher risk of heart attacks in the hour after consumption, but
the higher rate was not apparent for daily drinkers,” says Mostofsky. “It
may be that habitual alcohol intake affects enzymes that metabolize
alcohol, resulting in a lowered physiological response to each drink.”
“We know that drinking the same amount per week — but over the course of
fewer days — is harmful. So, modest alcohol consumption appears to be more
protective than either heavy drinking or no drinking at all. Once again, we
see that the people who regularly drink small amounts of alcohol have a
lower cardiovascular risk,” adds Mittleman.
4. Benefits and Risks Can Change Over Time
According to the HSPH, in general, risks of alcohol consumption exceed
benefits until middle age, when cardiovascular disease begins to account
for an increasingly large share of disease. In other words, for a
30-year-old man, the increased risk of alcohol-related accidents likely
outweighs the possible heart-related benefits of moderate alcohol
But for a 60-year-old man, a drink or two per day may offer protection
against heart disease that is likely to outweigh potential harm (assuming
he isn’t prone to alcoholism).
5. Alcohol Can Indirectly Impact Your Heart
Remember that even moderate drinking affects your body in other ways that
can indirectly impact cardiac health. For example, alcohol can disrupt
sleep. It can interact in potentially dangerous ways with a variety of
medications, including acetaminophen and other painkillers,
antidepressants, and sedatives.
And, don’t forget, alcoholic beverages contain an average of about 125 calories, according to the
National Institute on Alcohol Abuse and Addiction (NIAAA)
. When you add up the additional calories found in many festive cocktails,
the chance of adding extra pounds grows, too.
Above content provided by the CardioVascular Institute at Beth Israel
Deaconess Medical Center. For advice about your medical care, consult