A study to be presented at the 2024 Annual Scientific Session of the American College of Cardiology found that moderate to high alcohol consumption in both men and women was associated with an increased risk of developing heart disease. This link was more notable in women than in men.
The researchers, based at Kaiser Permanente of Northern California and led by Dr. Jamal Rana, enrolled 430,000 members, which included 243,000 men and 189,000 women over a two-year period between 2014 and 2015. The average age of participants was 44 years, and none had heart disease at time of obtaining data on alcohol consumption. During routine well-care visits, individuals were asked about how much alcohol they consumed. The degrees of alcohol consumption included low, moderate, high and binge drinking. Those who reported no alcohol consumption whatsoever were not include in the study.
The following metrics were used to describe degree of alcohol intake:
- Low intake was defined as one to two drinks per week for both men and women.
- Moderate intake was defined as three to 14 drinks per week for men and three to seven drinks per week for women.
- High intake was defined as 15 or more drinks per week for men and eight or more drinks per week for women.
- Binge drinking was defined as four or more drinks in one day for men and three or more drinks in one day for men at any point in the prior three months.
The study then monitored patients over the following four years to assess for development of heart disease. The focus was particularly on coronary artery disease, which is a condition affecting the blood vessels which supply blood to the heart muscle. Coronary artery disease typically develops when these vessels develop calcifications or plaques, making a person susceptible to chest pain (angina) or heart attacks (myocardial infarctions), due to reduced blood supply to the heart muscle, leading to scarring, cardiac dysfunction, irregular heart beats (arrhythmias), heart failure or death.
Just over 3,000 participants in the study developed coronary artery disease in the four years following the study’s onset. Those who reported high levels of alcohol intake had a higher likelihood of developing heart disease. In men, those with high intake had a 33% higher likelihood of developing heart disease than those with moderate intake. In women these differences were even more notable. Women reported high alcohol intake had a 45% higher likelihood of heart disease compared to those with low alcohol intake, and a 29% higher likelihood of heart disease compared to those with moderate intake. And women who reported binge alcohol intake (more than three drinks per day in the prior three months) had a 68% higher likelihood of heart disease than women who reported moderate intake.
In the past, it was considered that women had significantly lower risk of heart disease than men, in part due to demonstrable protective effects of estrogen in pre-menopausal years. While it is well documented that the hormone estrogen does offer protective effects on the heart, heart disease is the leading cause of death in women in the United States. Coronary artery disease is the most common cause of heart disease and death in women, due to unrecognized and/or inadequately managed high blood pressure. Alcohol consumption is one of the risk factors for developing high blood pressure and, in turn, heart disease.
It is becoming more and more apparent that heart disease in women often goes unrecognized. Women who describe symptoms of heart disease similar to those of men are more likely to be diagnosed with a gastrointestinal or mental health ailment than their male counterparts. It is now better understood how there are, indeed particular gender-specific risk factors for women’s heart disease, such as early- or late-onset menarche, presence of polycystic ovarian syndrome (PCOS), autoimmune disorders, certain disorders related to pregnancy, as well as the menopause transition. We can now include degree of alcohol consumption as a notable marker for risk of future cardiac issues in women.
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