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Alcohol and Heart Disease

By Susan Bernstein
WebMD Feature

Can you drink if you have heart disease? Moderate drinking should be OK, if your doctor approves, but you shouldn't count on alcohol to be a major part of your heart health plan.

"If you don’t drink alcohol now, there is no reason to start,” says Mark Urman, MD, a cardiologist at Cedars-Sinai Heart Institute in Los Angeles.

It's true that there have been studies linking drinking small amounts of alcohol -- no more than two drinks a day for men and one drink a day for women -- to better heart health.

But the exact link isn't clear. Those studies don't prove that the alcohol (whether it was wine, beer, or liquor) was the only thing that mattered.

Other lifestyle habits could have been involved, the American Heart Association notes. Or the important thing could have been nutrients that are in grapes, which you can get from the grapes themselves, without drinking wine.

“One drink a day is probably healthy for people with heart disease and those without it,” says James Beckerman, MD, a cardiologist at Providence St. Vincent Heart Clinic Cardiology in Portland, OR.

But whether or not you drink, you also need to keep the rest of your diet healthy, not smoke, and get regular exercise.

Drinking’s Modest Benefits

Light drinking “might thin the blood, reducing the risk of blood clots forming in the arteries of the heart,” Urman says. Drinking may also affect your cholesterol, in both good and bad ways.

“Alcohol may help increase HDL, the so-called ‘good’ cholesterol, around 10%,” Beckerman says. “But it can cause an increase in triglycerides," which are another type of blood fat.

If you drink mixed drinks, mixers like club soda and diet soda have no calories or sugar and may be better choices than sugary juices or soft drinks.

Drinking’s Risks

“Like many other things in life, too much of a good thing can be bad as well," Urman says.

Drinking more than one or two drinks a day could lead to heart problems, including making high blood pressure or atrial fibrillation (a common type of irregular heartbeat) worse, Beckerman says.

Drinking too much can make liver disease and some cancers, such as breast cancer, more likely, Urman notes.

What counts as one drink?

  • Wine: 4-5 ounces
  • Beer, regular or light: 12 ounces
  • Liquor: 1.5 ounces

If you find you're drinking more than the moderate amount, cut back. If you find that's tough to do, tell your doctor.

If you have congestive heart failure or take certain heart drugs (like some blood thinners, blood pressure-lowering medications, or cholesterol drugs), drinking may be unhealthy, so talk to your doctor about your risk, he says.

If you have ulcers or take anti-inflammatory drugs stronger than low-dose aspirin, drinking could cause stomach problems, Urman says. If you take a daily, low-dose aspirin, it’s safe to drink in moderation, Beckerman says.

When in doubt, ask your doctor. They can help you weigh the pros and cons of whether alcohol is OK for you, in light of your health history.

Reviewed on June 23, 2014

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