• Coronary heart disease is the third leading cause of death globally, with cisgender women at a higher risk.
  • A recent study shows a woman’s risk of developing heart disease may increase depending on the amount of alcohol consumed.
  • The findings suggest that women who binge drink have a 68% higher risk of developing heart disease compared to a 33% increased risk for men.

According to researchers, coronary heart disease is currently the third leading cause of death in the world and is linked to 17.8 million deaths each year.

A type of cardiovascular disease, coronary heart disease occurs when cholesterol builds up on the inside of artery walls, forming plaques that make it difficult for blood to flow to the heart.

Cisgender women are at a higher risk for developing coronary heart disease than men due to size and structural differences in the heart and hormonal changes that happen when a woman ages.

Now, researchers from Kaiser Permanente Northern California have found that a woman’s chance of developing coronary heart disease can also increase depending on the amount of alcohol consumed.

The study — presented at the American College of Cardiology’s Annual Scientific Session April 6–8 — also found men with a high intake of alcohol also had an increased risk of developing coronary heart disease. The research has yet to be published in a peer-reviewed journal.

According to Dr. Jamal Rana, a cardiologist with The Permanente Medical Group, an adjunct investigator in the Division of Research at Kaiser Permanente Northern California, and the lead author of this study, more awareness is needed on how alcohol can affect heart health.

“When we think about protection against heart disease, the first thing most people think of is: don’t smoke,” Dr. Rana told Medical News Today.

“I think a lot more awareness is needed that alcohol use can be a factor in heart disease risk and that asking about alcohol use should be part of routine health assessments moving forward. At Kaiser Permanente Northern California, alcohol use is considered a vital sign, and we ask about it and record the response at every medical appointment, the same way we record someone’s blood pressure.”

“There has long been this idea that alcohol is good for the heart — but more and more evidence is challenging that notion. Also, past studies that compared people who drink alcohol with people who abstain from drinking alcohol could not completely account for bias due to ‘sick quitters’ or ‘healthy users.’ We felt it was important to explore the relationship between levels of alcohol use, including heavy episodic drinking or binge drinking, and the risk of coronary heart disease in women and men.”

— Dr. Jamal Rana, lead study author

For this study, Dr. Rana and his team analyzed alcohol use data from more than 430,000 people who received care at Kaiser Permanente Northern California.

Study participants ranged in age from 18 to 65 and had no prior heart disease at the start of the study.

Participants were placed in three alcohol intake levels — low (one to two drinks per week for both men and women), moderate (three to 14 drinks per week for men and three to seven drinks for women), and high (15 or more drinks per week for men and eight or more drinks per week for women).

Additionally, researchers categorized study participants by whether they engaged in binge drinking or not.

Those who participated in binge drinking had five or more drinks per day in the past three months for men and four or more drinks per day in the past three months for women.

Scientists compared the relationship between alcohol intake levels reported by participants to coronary heart disease diagnoses received during the four years after.

Upon analysis, the researchers found that women who did not binge drink but reported high alcohol intake had a 45% increased chance of developing heart disease compared to female participants who reported moderate alcohol intake.

Scientists also discovered that women who fit the binge drinking category increased their heart disease risk by 68%.

“These findings suggest that we need to be educating women about potential heart risks associated with binge drinking,” Dr. Rana said.

“Our findings also underscore how important it is for healthcare providers to ask women not only how often they drink but if they binge drink.”

“Women process alcohol differently than men due to pharmacokinetic and physiologic differences. There has been an increasing prevalence of alcohol use among young and middle-aged women as women may feel they’re protected against heart disease until they’re older, but this study shows that even in that age group, women who drink more than the recommended amount of one drink per day or tend to binge drink, are at risk for coronary heart disease.”

— Dr. Jamal Rana, lead study author

The study also found that male participants with high alcohol intake had a 15% higher risk of heart disease compared to those reporting moderate alcohol intake.

Males with a high alcohol intake who also met the criteria for binge drinking had a 33% increased risk of heart disease.

The study also found that male participants with high alcohol intake and met the binge drinking category heightened their heart disease risk by 33% compared to those reporting moderate alcohol intake.

After reviewing this research, Dr. Jennifer Wong, a board certified cardiologist and medical director of Non-Invasive Cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA, told MNT she felt it was useful information about how alcohol might adversely affect the heart.

“It gives doctors additional evidence to present to patients when encouraging them to decrease their alcohol intake,” Dr. Wong explained.

“(For future research) it might be useful to see what the effects of cutting back would be in terms of cardiovascular outcomes, such as heart attack or myocardial infarction and deaths from cardiovascular causes.”

MNT also spoke with Monique Richard, a registered dietitian nutritionist and owner of Nutrition-In-Sight, who was not surprised by the study’s findings because while a little bit of a good thing can be beneficial, a lot of anything can be harmful.

“We know that excessive amounts of alcohol can contribute to an increase in blood pressure, dehydration, nutrient depletion, and displacement of, or an excess intake of, necessary and/or unnecessary calories,” Richard detailed.

“This can affect all organ systems, but specifically the strength and elasticity of the heart muscle, resiliency of the blood vessels, and lipid levels which in turn may increase risk factors or contribute to coronary heart disease.”

As past studies talk about the “healthy” factor of alcohol — such as the reported health benefits of red wine and that low amounts of alcohol are safe and could be beneficial to the cardiovascular system — understanding whether enjoying a glass or two of alcohol on a Saturday night can be a bit confusing.

When it comes down to it, Dr. Wong said no alcohol is best. “If drinking, we recommend no more than two drinks per day for men and one drink per day for women,” she added.

For those looking to cut back on their alcohol intake, Richard says to start by understanding what you may currently be consuming.

“At home, grab a measuring cup and compare the wine you’re pouring into the goblet to the recommended 5 ounces, or count how many beers have been consumed,” she continued.

“Ask yourself if you are able to easily taper that back in amount in addition to frequency.”

To help cut back on alcohol consumption, Dr. Wong and Richard shared additional tips:

  • Set realistic goals.
  • Start by decreasing the amount of alcohol, such as halving it, and cutting back from there.
  • Dilute alcoholic beverages such as a wine spritzer with seltzer water and fruit juice.
  • Drink a full cup (8 ounces) of water between alcoholic beverages.
  • Try mocktail recipes and explore “sober curious” elixirs.
  • Create an environment that is safe and conducive to your alcohol-related goals.
  • Observe feelings at the time of drinking alcohol, such as anxiety or stress, and look for alternatives to handling those emotions.
  • Seek out help from medical and healthcare professionals as needed.
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