Alcohol consumption has no additional preventative heart benefits in patients on cholesterol-lowering medication
A new study by researchers at Intermountain Healthcare finds that alcohol consumption does not provide additional heart benefits in cardiology patients already being treated with statins—the most commonly used drugs to lower cholesterol.
Previously, some observational studies have linked drinking alcohol, such as red wine, with reducing the risk of coronary heart disease. However, the new Intermountain study failed to demonstrate any added benefit for patients taking statins to control their cholesterol.
"Recommending alcohol for heart health is a controversial topic, although past observational studies have suggested [some] benefit," said Jeffrey L. Anderson, cardiologist at Intermountain Healthcare and principal investigator of the study. "However, more recent reports have questioned this."
In the Intermountain study, researchers examined how alcohol affected specific groups of heart patients, including those without prior known heart disease (primary prevention group) and those with known heart disease (secondary prevention group), and those taking and not taking statins in these two groups.
"While we did see some protective heart benefits for our patients not on a statin in the primary prevention group, we also found that it didn't help those statin-taking patients in either the primary or secondary prevention groups," Dr. Anderson noted.
Findings of this retrospective population study were presented this week at the American College of Cardiology Scientific Sessions in Washington, D.C.
In the study, researchers examined Intermountain patients who underwent diagnostic coronary angiography to determine whether they had coronary artery disease and, if so, whether they needed a stent or bypass surgery. About one third had normal coronary arteries.
At intake, these patients were also asked if they used alcohol as part of a comprehensive survey of personal lifestyle and other health habits. Of the alcohol drinkers, 416 were on statins and 164 were not. Of the non-drinkers, 313 were on statins and 808 were not.
The Intermountain research team then looked at how many patients in each category experienced a major adverse cardiac event (MACE), such as a heart attack or stroke, within the next four years.
The researchers found that primary prevention patients who drank alcohol and were not on a statin did have lower rates of major adverse cardiac events than non-statin taking patients who did not drink.
However, in primary prevention patients already on a statin, they found no difference in MACE and death rates whether they drank or not. In the secondary prevention group, alcohol did not reduce the risk of MACE whether or not these patients were taking a statin.
These findings are important, said Dr. Anderson, because of conflicting views on alcohol use, especially in light of both higher rates of alcohol abuse during the COVID pandemic, and the World Health Organization's recent position statement that any alcohol consumption is bad for your health.
It also finds support in a current study by researchers at Massachusetts General Hospital and the Broad Institute of MIT and Harvard, which suggests that the supposed benefits of alcohol consumption may be explained by other healthy lifestyle factors that are common among light to moderate drinkers.
Dr. Anderson added that larger and more in-depth studies, like that from Harvard and MIT, will further clarify the possible links between drinking alcohol, the amount and type of alcohol consumption, and heart health.
"We, as physicians, struggle with what to tell our patients about alcohol consumption in light of these new findings, especially since we know that higher levels of consumption have cascading negative health risks," Dr. Anderson noted. "If further confirmed, our findings may help us in our recommendations to patients about their personal choices about alcohol consumption as well as to inform professional medical society recommendations about alcohol use and heart health."