Don't drink a toast to your health

Alcohol and Heart Disease

Ahmed A. Tawakol, MD

Art by Sefira Lightstone

Previous research has shown an association between drinking alcohol and having a lower risk of heart disease, according to the American College of Cardiology.

However, scientists didn’t understand the reasons for the potentially protective effects. Potential explanations included that people who had a drink or two per day also ate a healthier diet, or maybe they happened to exercise regularly. Genetic factors or socioeconomic factors also could play a role.

A new Mass General Brigham study has shed some light on the relationship between alcohol and heart health: Researchers found that light-to-moderate drinking is associated with long-term reductions in stress signals in the brain. The study, published in the Journal of the American College of Cardiology, also found that lower stress signals were associated with fewer heart attacks and strokes.

But that doesn’t mean you should toast to your heart health, says Mass General Brigham cardiologist Ahmed Tawakol, MD, a senior author on the paper. Dr. Tawakol cares for patients at Massachusetts General Hospital. He emphasizes that alcohol also has negative effects. Even light alcohol intake increases cancer risk, and higher amounts can negatively affect brain health.

“This new information offers an important message that we should implement other ways to lower stress signals in the brain, without the potential adverse effects of alcohol,” says Dr. Tawakol.

Can drinking alcohol reduce heart disease risk?

The researchers evaluated data from more than 50,000 patients in the Mass General Brigham Biobank. The large database houses genetic, lifestyle, and environmental information about individuals who agree to participate. Researchers can use the data to better understand how these factors interact and affect health.

The study found that those who reported consuming light to moderate amounts of alcohol had lower long-term rates of heart attacks and strokes. This was true even when the researchers accounted for a broad range of possible contributing factors, including other lifestyle factors, genetic factors, socioeconomics factors like income and education levels, and general health.

The research team then studied a smaller group of those patients, 754 individuals who also had brain imaging on file. When the research team looked for stress-related activity in the brain, they found that alcohol use over time quiets the amygdala. This small structure in the brain plays a role in emotion, stress response, and behavior.

This association between alcohol and heart health appears to be even more pronounced in people with high levels of stress. “We found that alcohol consumption was twice as impactful at reducing heart attacks among individuals with a history of anxiety,” Dr. Tawakol says.

What is “light to moderate drinking”?

The U.S. Department of Health and Human Services (HHS) recommends no more than one drink a day for women and one or two drinks a day for men. One drink is defined as:

• 12 ounces of beer

• 4 ounces of wine

• 5 ounces of 80-proof spirits

Be aware that “one drink” may be less than you expect. It can also be hard to gauge how much alcohol is in a drink. Whether you’re pouring a glass of wine at home or ordering a drink at a restaurant, your alcohol consumption could be a lot higher than you’d realize. A cocktail like a margarita could have several ounces of higher-proof spirits.

How to improve heart health without alcohol

Dr. Tawakol hopes the study encourages people to focus on healthy ways to reduce stress signals in the brain — not necessarily on alcohol consumption.

“The link between alcohol and health is complicated. There have been a lot of studies that demonstrate adverse effects of alcohol. So, it shouldn’t be something people choose simply for the purpose of improving their health,” he says.

Heavy alcohol use can increase risk of several health conditions, including:

• Cancer

• Cardiomyopathy, a disorder of the heart muscle

• High blood pressure

• Heart failure

• Obesity

• Problems with balance, memory, speech, and judgment

• Stroke

Dr. Tawakol suggests other healthy ways to reduce stress and boost heart health:

• Do mindfulness exercises.

• Get regular exercise.

• Meditate or practice yoga.

• Practice good sleep hygiene.

• Spend time with friends and family, and do things you love.

• Try journaling, coloring, being in nature, or listening to music.

“We should double down on the goal of stress reduction by seeking other approaches,” he explains. “Don't drink alcohol solely for health benefits. But if you do drink, aim to do so in moderation.”