One-a-day drink ‘raises heart disease risk’ says cardiologist – not coffee

Women who drink as little as a daily glass of wine and two at weekends face a “significantly higher” risk of developing heart disease, a study warned. American researchers found that women who consume more than eight alcoholic drinks a week were nearly 50 per cent more likely to develop the potentially fatal condition.

Binge drinkers of both sexes were also found to be at considerably greater risk of heart disease. The 2024 study from the American College of Cardiology (ACC) — one of the largest investigations into the link between alcohol and coronary heart disease ever undertaken — cautioned that heavy-drinking young and middle-aged women were particularly vulnerable, regardless of their age.

Heart attacks and other forms of heart disease are currently increasing among younger generations in both the US and the UK. Coronary heart disease develops when the arteries supplying blood to the heart become narrowed, restricting blood flow.

This condition can trigger chest pain and acute episodes such as heart attacks. Alcohol consumption and episodic drinking — or binge drinking — have also increased amongst female populations in recent decades.

“When it comes to binge drinking, both men and women with excess alcohol consumption had a higher risk of heart disease,” explained Dr Jamal Rana, a cardiologist and lead author of the study. “For women, we find consistently higher risk even without binge drinking. I wasn’t expecting these results among women in this lower age group because we usually see increased risk for heart disease among older women. It was definitely surprising.”

The research team drew upon data from more than 430,000 individuals who received treatment through the Kaiser Permanente Northern California integrated health organisation. The study group comprised nearly 243,000 men and 189,000 women with an average age of 44, none of whom had been diagnosed with heart disease at the outset.

Details regarding alcohol consumption were gathered during primary care appointments using the health organisation’s standard ‘Alcohol as a Vital Sign’ screening initiative, which incorporates visual reference posters to assist patients in estimating their alcohol intake according to standard measurements. The researchers examined the connection between patients’ drinking levels, recorded during routine check-ups in 2014 and 2015, and coronary heart disease diagnoses over the subsequent four years.

Drawing on self-reported assessments, researchers divided participants’ overall alcohol consumption into three categories: low (one to two drinks per week for both men and women), moderate (three to 14 drinks per week for men and three to seven drinks per week for women), or high (15 or more drinks per week for men and eight or more drinks per week for women). Researchers individually classified each participant according to whether they engaged in binge drinking — defined as consuming more than four drinks for men or more than three drinks for women in a single day within the past three months — or not. Those who reported no alcohol consumption were excluded from the study, and the data was adjusted to account for age, physical activity, smoking and other established cardiovascular risk factors.

A total of 3,108 patients were diagnosed with coronary heart disease during the four-year follow-up period, and researchers discovered that the incidence of coronary heart disease rose with greater levels of alcohol consumption. Among women, those who reported high alcohol intake faced a 45 per cent greater risk of heart disease compared with those reporting low intake, and a 29 per cent higher risk compared with those reporting moderate intake.

Binge-drinking heart warning

The most striking disparity, however, was found amongst individuals in the binge drinking category — with women in this group being a staggering two-thirds more likely (68 per cent) to develop heart disease compared to those with a moderate alcohol intake.

Men with a high overall intake were also a third (33 per cent) more likely to develop heart disease compared with men who reported a moderate intake. The findings revealed no significant difference in risk between those who reported moderate versus low alcohol intake, regardless of whether they were also classified as binge drinkers.

“Women feel they’re protected against heart disease until they’re older, but this study shows that even when you’re young or middle-aged, if you are a heavy alcohol user or binge drink, you are at risk for coronary heart disease,” Dr Rana said.

Research has demonstrated that alcohol raises blood pressure and triggers metabolic changes linked to inflammation and obesity, with women also metabolising alcohol differently to men. Dr Rana and his team cautioned that their findings highlight the health dangers of alcohol consumption and the importance of factoring in alcohol use when assessing and preventing heart disease risk.

“When it comes to heart disease, the number one thing that comes to mind is smoking, and we do not think about alcohol as one of the vital signs,” Dr Rana added. “I think a lot more awareness is needed, and alcohol should be part of routine health assessments moving forward.”

One drawback of the study – which Dr Rana presented at the ACC’s Annual Scientific Session in Atlanta, Georgia, on April 6 2024 – was that patients are widely thought to under-report their alcohol intake. Consequently, the researchers suggest their study’s estimates of heart disease risk associated with alcohol consumption are likely to be ‘conservative’.