Moderate Drinking Decreases Risk of Heart Attack in Men With Hypertension, Study Finds

A team of scientists at the Harvard School of Public Health (HSPH) has found that men with hypertension have a 30 percent lower risk of having a heart attack if they drink a glass or two of wine per day.

Previous studies have found that moderate alcohol consumption is linked with lower risk of cardiovascular heart disease in participants without hypertension. In similar studies, scientists examined an otherwise healthy population and then charted the rate of cardiovascular events occurring, be it atherosclerosis, coronary heart disease or heart attacks. In this latest study, however, the participants had already been diagnosed with high blood pressure.

"This was the first study to our knowledge that examined the risk of heart attacks among men with high blood pressure who drank moderately," said lead author Joline Beulens, a visiting scholar at HSPH from Wageningen University in the Netherlands when the study began. The study was published in the Jan. 2 issue of the Annals of Internal Medicine. "Because excess alcohol intake clearly increases blood pressure, many men with hypertension are counseled not to drink, but our results suggest that may not be necessary if men drink safely and responsibly."

According to the study, 65 million Americans were diagnosed in 1999 with hypertension, or high blood pressure, which is often caused by stress, lack of adequate exercise and a poor diet. Over time, the prolonged strain on the heart and blood vessels may lead to a heart attack or heart failure; sufferers show a two-fold increased risk of cardiovascular disease. Hypertension is also linked with incidents of stroke and, in rarer cases, kidney failure.

The researchers analyzed data from 11,711 hypertensive American men from the Health Professionals Follow-Up Study, which was launched in 1986 to evaluate men's health and its impact on serious illnesses, such as cancer and heart disease. Every four years, the participants filled out a survey and noted the frequency with which they drank beer, red wine, white wine and liquor. The researchers found that drinking moderately every day, regardless of beverage type, provided the best protection. However, the scientists added that in many previous studies red wine was found to provide greater heart health, especially when red wine is the main choice of alcoholic beverage.

Subjects were classified according to the amount of alcohol they consumed every day. One of the strengths of the study was that the groups of men did not change their alcohol consumption habits with the diagnosis of hypertension. Cases of nonfatal heart attacks, fatal heart disease and stroke were documented from 1986 to 2002. During that time, 653 heart attacks were recorded, with 279 being fatal and 374 non-fatal. In all, 1,145 deaths occurred.

When compared to nondrinkers, men with high blood pressure who were moderate drinkers (roughly 1 to 2.5 glasses of wine per day) were 30 percent less likely to have a heart attack. Drinkers who consumed a little more or a little less than the nondrinkers also showed a 30 percent lower risk. Very-light drinkers--less than half a glass per day--showed a risk similar to nondrinkers.

Heavy drinkers--more than four drinks per day--showed the lowest risk of a heart attack, with a 60 percent lower chance than nondrinkers, but the study's authors warned that this group was very small (and less statistically significant), with 13 heart attacks recorded among the 450 men in this category. In contrast, more than half the men in the study were classified as nondrinkers or very-light drinkers.

"It is important for all individuals with high blood pressure to discuss their alcohol intake with their physicians, as heavy consumption, even occasionally, can raise blood pressure," said co-author and noted alcohol-and-health researcher Kenneth Mukamal, M.D., an associate professor of medicine at Harvard Medical School. "However, our results suggest that men with high blood pressure seem to have the same lower risk associated with moderate drinking that other men do."