To drink or not to drink? That is the perennial conundrum among people with cardiovascular issues.
For 50-year-old Rayan Arora, a businessperson from Delhi, a sudden chest pain signalled that he had angina, post an angiography recommended by his cardiologist. “I was taking a walk when I got this pain in the centre of the chest and after investigations, I have now been recommended for angioplasty,” he says.
A regular drinker who could not do without alcohol five days a week, Arora has now reduced his consumption to two times a week. “My doctor knew I was habituated so instead of completely stopping it, he told me to reduce it,” he says. “I have around three pegs of whisky [in a drinking session] along with some protein like chicken snacks.”
While experts don’t recommend teetotallers taking up drinking for heart health, moderate drinkers can heave a sigh of relief.
“One can have a goblet of red or white wine daily, only because it has a lesser concentration of alcohol,” says Dr Shikha Sharma, nutritionist and director at NutriHealth Systems, Delhi. “Beers, too, have less alcohol content. It is better not to take hard drinks since something like, say, whisky has a remarkably high amount [of alcohol content]. And then too, it depends on the person’s ability and whether they have the enzymes to metabolise it. So, when you have any kind of heart disease, alcohol consumption must be only if your doctor is okay with it.”
Alcohol and heart health
According to a 2021 study published by BioMed Central (BMC), the association between alcohol consumption and prognosis in individuals with pre-existing cardiovascular disease (CVD), shows that an alcohol intake up to about 105gm (or equivalent to 13 UK units, with one unit equal to half a pint of beer/lager/cider, half a glass of wine or one measure of spirits) a week is associated with lower risks of both mortality and subsequent cardiovascular events among CVD patients.
There are also said to be protective effects of alcohol against CHD (coronary heart disease), according to a 1996 research article published in Circulation, journal of the American Heart Association.
It says that more than a dozen prospective studies have demonstrated a consistent, strong, dose-response relation between increasing alcohol consumption and decreasing incidence of CHD. Consumption of one or two drinks per day is associated with a reduction in risk of approximately 30 to 50 per cent.
Manas Bhattacharya, a 39-year-old advertising professional from Noida, was diagnosed with extremely high blood pressure and also left ventricular hypertrophy. “I have completely quit smoking, have started physical exercises and don’t drink daily any more, but I do have one or two [drinks] each weekend as it has been a habit for long.”
How much alcohol can a heart patient drink?
Can alcohol have any beneficial effects on the heart? “There are studies where it is shown that there is association between moderate intake and lower risk of dying from heart disease,” says Dr Tapan Ghose, director and HOD, cardiology, Fortis Hospital, Vasant Kunj, New Delhi. “But it is difficult to determine cause and effect.”
Dr Mukesh Goel, senior consultant, cardiothoracic surgery, Indraprastha Apollo Hospitals, Delhi, says, “The effect of alcohol on the heart is complex. For some people, drinking even moderate amounts of alcohol causes major cardiovascular risks. Consumption of moderate amounts of alcohol may help by raising HDL [high-density lipoprotein] or ‘good’ cholesterol, preventing blood from clotting. This can be good or bad. It may hold off heart attacks, but it could make you bleed more easily. It also helps prevent damage caused by high LDL [low-density lipoprotein], the ‘bad’ cholesterol.”
Moderate alcohol consumption means an average of one to two drinks per day for men and one drink per day for women.
Diverse types of beer, wine and liquor have different amounts of alcohol. But in general, a drink is one 12-ounce regular beer, five ounces of wine or 1.5 ounces of 80-proof spirits (such as bourbon, vodka and gin).
As for red wine, the link between red wine and a healthy heart may be due to the elevated level of micronutrients, called polyphenols, found in the skin and seeds of grapes.
The polyphenols in red wine have antioxidant properties. This means they prevent or reduce the oxidation of LDLs. It can also increase the level of HDL in the blood, which is associated with a lower risk of cardiovascular disease.
HDL cholesterol is good because it helps remove excess LDL cholesterol from the blood vessels.
Some research has found that drinking red wine may decrease platelet aggregation, which can also help reduce the risk for cardiovascular disease. In order to receive the heart health benefits of red wine, it is always advisable to consume one drink a day for women and two a day for men, says Dr Goel of Apollo Hospitals.