Talk:Alcohol and cardiovascular disease

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Please

Please note: This entry does not constitute original research according to Wikipedia guidelines:

“Original research that creates primary sources is not allowed. However, research that consists of collecting and organizing information from existing primary and/or secondary sources is strongly encouraged. In fact, all articles on Wikipedia should be based on information collected from primary and secondary sources. This is not ‘original research,’ it is ‘source-based research,’ and it is fundamental to writing an encyclopedia.”

Thank you.David Justin 16:16, 12 January 2006 (UTC)

Please see Wikipedia:Cite sources. Also, we should consider merging this into Alcohol and health. Kaisershatner 19:41, 30 January 2006 (UTC)

Fillmore's meta-analysis

The following paper was widely cited in the non-scientific press:

Kaye Fillmore et al. "Moderate alcohol use and reduced mortality risk: systematic error in prospective studies." Addiction Research and Theory. Advanced online publication March 30, 2006.

This paper claims that the conclusions were distorted by people who had to abstain from alcohol because of health problems. This seems to disagree with the statement on the article page that the effect remains if one filters for such effects. Maybe someone knowledgeable could say a few words about this. Han-Kwang, 23 April 2006

Actually the Fillmore paper suggests that the conclusions of a causal relationship between the moderate consumption of alcohol and reduced mortality *may* have been distorted because of the non-disaggregation issue in some studies. Unfortunately, Fillmore's analysis omitted a number of important studies, omitted all non-prospective studies, and did not address the fact that many of the physiological mechanisms whereby alcohol leads to improved cardiovascular health and dramatically reduced mortality are now documented and understood. In short, the paper only looks at a part of the total picture.Medical Man 15:50, 23 April 2006 (UTC)

Yes, but it looks at the most important part. The Fillmore paper, now published in Addiction Research & Theory, 14(2) 2006. 101-132, looks at prospective studies (always considered a better research design than retrospective, though typically much more expensive to conduct) specifically to determine if patients had been misclassified as abstainers but really had reduced or stopped previous drinking patterns. Upon analyzing the resulting data, taking into consideration 54 published studies, the authors found that the studies judged to be error-free did not demonstrate significant cardiac protection from alcohol. I'll update the entry. Drgitlow 19:52, 4 July 2006 (UTC)

Not sure Fillmore's concern's should merit anything more than one sentence of historical interest. The vast majority of researchers do not agree with her. And yes, I will mention she is a sociologist. EtherDoc (talk) 06:11, 31 December 2012 (UTC)

Source

Hi Wham- Please note that I created this page (Alcohol and cardiovascular disease) on 30-9-05 using Alcohol and Health as the Source. Therefore, it is not spam. Thanks. David Justin 14:53, 7 March 2007 (UTC)on 30-9-05

Source information

Hi Wham- Please note that I created this page (Alcohol and cardiovascular disease) on 30-9-05 using Alcohol and Health as the Source. Therefore, it is not spam. Thanks.David Justin 18:01, 8 March 2007 (UTC)

Important

Hi Wham- Please note that I created this page (Alcohol and cardiovascular disease) on 30-9-05 using Alcohol and Health as the Source. Therefore, it is not spam. Thanks.David Justin 16:20, 9 March 2007 (UTC)

Documentation

Hi Wham- Please note that the materials in bold in the following Wikipedia entry are from “Alcohol and Health” and “Alcohol Protective Against Coronary Heart Disease (CHD).”

The evidence demonstrates that the entry was sourced from those web pages, and indicating that fact does not constitute spam. To the contrary, it is proper documentation and consistent with Wikipedia guidelines. Thanks.David Justin 00:55, 19 March 2007 (UTC)

The subject of alcohol and heart attacks is important because the major cause of death in many countries is heart disease.

Research indicates that moderate drinkers are less likely to suffer heart attacks than are abstainers or heavy drinkers (Anani et al.; Gaziano et al.; Manson et al‘’’; Mulcamel et al.; National Institute on Alcohol Abuse and Alcoholism; Rimm et al.; Sesso et al.; Simons et al.; Walsh et al.). The first scientific study of the relationship between alcohol consumption and atherosclerosis was published in the Journal of the American Medical Association in 1904. Public awareness of the French Paradox in the early 1990s stimulated increased interest in the subject of alcohol and heart disease.

An exhaustive review of all major heart disease studies has found that "alcohol consumption is related to total mortality in a U-shaped manner, where moderate consumers have a reduced total mortality compared with total non-consumers and heavy consumers"(La Porte et al .). Research also reportsthat the risk of a heart attack among moderate drinkers with diabetes is 52 percent lower than among nondrinkers and that the risk of dying in the four years after a heart attack is 32 percent lower among those who were moderate drinkers in the year before the attack (Beulens et al.).

Debate over research methods

Ex-drinkers versus never-drinkers

A logical possibility is that many of the alcohol abstainers in research studies previously drank excessively and had undermined their health, thus explaining their high levels of risk. To test this hypothesis, some studies have excluded all but those who had avoided alcohol for their entire lives. The conclusion remained the same in some studies: moderate drinkers are less likely to suffer heart disease. More recently, however, Fillmore et al failed to find significant support: analyzing 54 prospective studies, the authors found that those studies which were free of the error (including former drinkers in the abstaining group) did not demonstrate significant cardiac protection from alcohol, although they continued to exhibit a J-shaped relationship in which moderate drinkers were less likely (but not at a statistically significantly level of confidence) to suffer cardiac disease than lifelong abstainers (Addiction Research & Theory, 14(2) 2006. 101-132). The sociologist says research is needed that looks at the reasons people abstain, which hers did not do. Cardiologist Dr. Arthur Klatsky notes that Fillmore’s study, which she freely acknowledges proves nothing but only raises questions, is itself seriously flawed. To overcome the inherent weaknesses of all epidemiological studies, even when properly conducted, he calls for a randomized trial in which some subjects are assigned to abstain while others are assigned to drink alcohol in moderation and the health of all is monitored for a period of years [1]

Other factors

Another possibility is that moderate drinkers have more healthful lifestyles (making them healthier), higher economic status (giving them greater access to better foods or better healthcare), higher educational levels (causing them to be more aware of disease symptoms), etc. However, when these and other factors are considered, the conclusion again remains the same: moderate drinkers are less likely to suffer heart disease.

Possible mechanisms of any benefit

Given the epidemiological evidence that moderate drinking reduces heart disease, it becomes important to examine how alcohol might confer its cardiovascular benefits. Can alcohol’s protective affects be explained physiologically? Research suggests that moderate consumption of alcohol improves cardiovascular health in a number of ways (Facchini et al), including the following.

I. Alcohol improves blood lipid profile. A. It increases HDL ("good") cholesterol. B. It decreases LDL ("bad") cholesterol.

II. Alcohol decreases thrombosis (blood clotting). A. It reduces platelet aggregation. B. It reduces fibrinogen (a blood clotter). C. It increases fibrinolysis (the process by which clots dissolve).

III. Alcohol acts through additional ways. A. It reduces coronary artery spasm in response to stress. B. It increases coronary blood flow. C. It reduces blood pressure. D. It reduces blood insulin level. E. 'It increases estrogen levels.

There is a lack of medical consensus about whether moderate consumption of beer, wine, or distilled spirits has a stronger association with heart disease. Studies suggest that each is effective, with none having a clear advantage. Most researchers now believe that the most important ingredient is the alcohol itself

The American Heart Association has reported that "More than a dozen prospective studies have demonstrated a consistent, strong, dose-response relation between increasing alcohol consumption and decreasing incidence of CHD (coronary heart disease). The data are similar in men and women in a number of different geographic and ethnic groups. Consumption of one or two drinks per day is associated with a reduction in risk of approximately 30% to 50%"

Heart disease is the largest cause of mortality in the United States and many other countries. Therefore, some physicians have suggested that patients be informed of the potential health benefits of drinking alcohol in moderation, especially if they abstain and alcohol is not contraindicated. Others, however, argue against the practice in fear that it might lead to heavy or abusive alcohol consumption. Heavy drinking is associated with a number of health and safety problems.

References

British Medical Journa [http://bmj.bmjjournals.com/cgi/content/full/332/7552/0-c "Alcohol drinking patterns have different CHD outcomes in men and women"

• "British Medical Journal" "Prospective study of alcohol drinking patterns and coronary heart disease in women and men"
• Anani, U. A., et al. Alcohol consumption and risk of coronary heart disease by diabetes status. Circulation, 2000, 102, 500-505.
• Barefoot, J. C., et al. Alcoholic beverage preference, diet, and health habits in the UNC Alumni Heart Study. American Journal of Clinical Nutrition, August 2002 v76 i2, 466-472.
• Beulens, J., et al. Alcohol consumption and risk of type 2 diabetes among older women. Diabetes Care, 2005 (December), 28, 2933-2938.
• Gaziano, J., et al. Potential mortality benefits for drinkers with previous heart attacks. The Lancet, 1998, 352, M 1882-1885.
• La Porte, R., et al. Coronary heart disease and total mortality. Recent developments in Alcoholism, 1985, 3, 157-163.
• Manson, J. E., et al. Prevention of Myocardial Infarction. New York: Oxford University Press, 1996.
• Mulcamel, K.J., et al. Alcohol consumption after myocardial infarction. Journal of the American Medical Association, 2001, 285(15), 1965-1970.
• Mulcamel, K.J., et al. Alcohol and AMI: Benefits from beer, wine, and liquor. American Journal of Nursing, 2001, 101(8), 18.
• National Institute on Alcohol Abuse and Alcoholism. Alcohol Alert, No. 45. October, 1999.
• Rimm, E., et al. Prospective study of alcohol consumption and risk of coronary disease in men. The Lancet. 1991, 338, 464-468
• Sesso, H.D., et al. Seven-year changes in alcohol consumption and subsequent risk of cardiovascular disease in men. Archives of Internal Medicine, 2001, 160, 2505-2612.
• Simons, L. A., et al. Moderate alcohol intake is associated with survival in the elderly: the Dubbo Study. The Medical Journal of Australia, 2000, 172, 121.
• Walsh, C. R., et al. Alcohol consumption and risk of congestive heart failure in the Framingham Heart Study. Annals of Internal Medicine, 2002, '136(3), 181-191.

Association with health problems of non-drinking ethnic groups?

I understand that many people originating from India for example do not drink alcohol. Yet in Britain at least this ethnic group is known to have a much higher rate of health problems such as diabetes etc. Could this explain the link between abstainers and heart problems compared with moderate drinkers? Any papers about this? —Preceding unsigned comment added by 80.2.196.19 (talk) 17:49, 21 June 2008 (UTC)

Ethnic health link perhaps?

My first version of this disapeared into cyberspace so here is a shortened version. In Britain people originating from India etc are known to have a much higher rates of diabetes and other health problems, and also abstain from alcohol. Could this explain the link between abstaining and more heart disease than moderate drinkers? Any papers on this? What about the health of Mormons? —Preceding unsigned comment added by 80.2.196.19 (talk) 17:56, 21 June 2008 (UTC)

Mormons, who are not supposed to drink, apparantly live much longer than other people Word_of_Wisdom#Health_studies_regarding_Latter-day_Saints 80.2.200.127 (talk) 19:50, 21 June 2008 (UTC)

Irresponsible article.

The opener of the article reads like written by a college student trying to justify drinking all day. Rename it 'benefits of moderate alcohol intake in the case of..' cause you're gonna kill people. --Leladax (talk) 21:15, 31 October 2008 (UTC)

alcohol?

I'm not aware of any studies where people drank just alcohol. They all drank wine or bear or etc. These are compounds of diverse parts - not just alcohol. Why doesn't this article spend any time discussing this issue? see Flavonoid#Wine Smkolins (talk) 17:32, 16 June 2009 (UTC)

Effect sizes

Typical of wikipedia, this article is misleading because it tries to pose as scientific research. When you report research findings you must do more than simply state "Group 1 were significantly more at risk of heart disease than Group 2". Effect sizes must be reported too, otherwise the results are impossible to properly interpret. Statistical significance is not the same as clinical significance[2]. Nicolasconnault (talk) 06:18, 11 June 2010 (UTC)

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Wine

doi:10.1161/CIRCULATIONAHA.117.030387 JFW | T@lk 07:55, 10 October 2017 (UTC)