Could Alcohol Increase Acute Risk of Heart Attack and Stroke?

People have acutely higher cardiovascular risk following any alcohol consumption, but by 24 hours, only heavy alcohol intake conferred continued risk, according to a new study.

“Although there has been a great deal of research on the health effects of habitual alcohol consumption, the acute risk of heart attacks and strokes in the hours following alcohol intake have not been well characterized,” said lead study author Elizabeth Mostofsky, ScD, of the department of medicine at Boston’s Beth Israel Deaconess Medical Center. “We were delighted to find that information on close to 30000 participants could be used to synthesize the information on this important topic so that we could gain insight on the risk of heart attacks and strokes in the subsequent hours and days.”
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The researchers searched CINAHL, Embase, PubMed, and PsycINFO from inception to March 12, 2015, supplemented with manual screening for observational studies assessing the association between alcohol intake and cardiovascular events in the following hours and days. They then calculated pooled relative risks (RRs) and 95% confidence intervals (CIs) for the association between alcohol intake and myocardial infarction (MI), ischemic stroke (IS), and hemorrhagic stroke (HS) using DerSimonian and Laird random-effects models to model any alcohol intake or dose-response relationships of alcohol intake and cardiovascular events.

Among 1056 citations and 37 full-text articles reviewed, they included 23 studies (29457 participants). The investigators found moderate alcohol consumption was associated with an acutely higher cardiovascular risk that was attenuated after 24 hours and even protective for MI and HS (≈2-4 drinks: RR=30% lower risk), and protective against IS within 1 week (≈6 drinks: RR=19% lower risk). In contrast, heavy alcohol drinking was associated with higher cardiovascular risk in the following day (≈6-9 drinks: RR=1.3-2.3) and week (≈19-30 drinks: RR=2.25-6.2).

“Based on these results, it is possible that the brief risk is outweighed by the health benefits of regularly drinking moderate amounts of alcohol,” Mostofsky said. “Therefore, if you drink alcohol, do so in moderation. This means no more than 2 drinks per day for men and 1 drink per day for women.”

Future studies will need to evaluate whether there’s any racial/ethnic variation in the acute effects of alcohol intake on cardiovascular risk and whether genetic differences play a role, she said.

-Mike Bederka

Reference:

Mostofsky E, Chahal HS, Mukamal KJ, et al. Systematic review and meta-analysis of acute effects of alcohol consumption on risk of cardiovascular events. EPI/Lifestyle 2016 Scientific Sessions, Phoenix, Ariz. March 3, 2016.