In a recent study published in JAMA network open, group of researchers investigated the association between reduced alcohol consumption and the occurrence of major adversarial cardiovascular events (MACE) in heavy drinkers, specializing in different subtypes of heart problems (CVD).

Test: Decreased alcohol consumption and major adversarial cardiovascular events amongst individuals who previously consumed large amounts of alcohol. Photo credit: Vaclav Mach / Shutterstock

Background

Alcohol consumption significantly affects the health of people and society, and research shows its complex relationship with cardiovascular diseases. Although moderate or moderate drinking is believed to supply some protection against heart problems, this effect varies depending on the sort of heart problems, and the connection between alcohol consumption and heart health isn’t linear. Previous studies have typically measured alcohol consumption at one time limit and compared drinkers with non-drinkers, without taking into consideration changes in drinking habits over time. Further research is obligatory to grasp the mechanisms underlying the cardiovascular advantages of reduced alcohol consumption and to ascertain guidelines tailored to different populations and CVD subtypes.

Concerning the study

In the current study, researchers used data from the Korean National Health Insurance Service-Health Screening (NHIS-HEALS) database to look at a representative sample of Korean adults aged 40 to 79 years. Approved by the Institutional Review Board (IRB) of Chungbuk University Hospital and in accordance with the Declaration of Helsinki and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, the study used the broad scope of the National Health Screening Program (NHSP) to investigate information on demographics, medical history and lifestyle aspects, including alcohol consumption. This careful documentation provided the idea for detailed research into the health effects of alcohol.

The collection of participants was methodical, excluding recent non-drinkers to avoid confounding aspects comparable to the effect of quitting drinking. The rigorous study involved defining heavy drinking based on established criteria and dividing participants into groups based on their drinking habits over time.

Confounding variables were precisely identified, including a spread of demographic, health and lifestyle aspects. Study outcomes focused on MACE, with detailed coding and procedures to make sure accuracy. Statistical analyzes were performed using sophisticated tools and methods, including propensity rating matching (PSM) and multivariable Cox proportional hazards regression models, to attract reliable conclusions in regards to the association between alcohol consumption and cardiovascular health.

Findings

In a comprehensive study that analyzed 21,011 participants who initially consumed high levels of alcohol, 14,220 maintained their heavy drinking habits and 6,791 reduced their drinking to mild or moderate levels. This cohort, composed primarily of men (90.3%) and on average 56 years of age, provided an in depth picture of baseline health and lifestyle characteristics. Initially, heavy drinkers were, on average, younger and had a greater proportion of men than those that reduced their alcohol intake.

Clinical indicators comparable to body mass index (BMI), blood pressure and various biochemical markers showed differences between groups, with regular heavy drinkers presenting poorer health indicators. Interestingly, despite differences in health status, after PSM these groups were closely similar on most variables, which allowed for a more accurate comparison of results.

Over the course of the study, the incidence of MACE was significantly higher within the group that continued heavy drinking in comparison with those that in the reduction of, with significant variation in results over time. Specifically, reducing alcohol consumption was related to a 23% lower risk of MACE. Taking a look at specific cardiovascular diseases, reducing alcohol consumption was found to significantly reduce the chance of coronary artery disease (CAD), angina, stroke, ischemic stroke, and all-cause mortality, but no profit was observed for nonfatal myocardial infarction or hemorrhagic stroke.

Subgroup analyzes highlighted the cardiovascular advantages of reducing alcohol consumption across quite a lot of demographic groups and health conditions, including age, gender, BMI, smoking status, and physical activity level. Of note, these advantages were evident no matter pre-existing conditions, comparable to atrial fibrillation and chronic kidney disease, and were consistent across socioeconomic status and comorbidities.

Further sensitivity analyzes that excluded variables potentially modifiable by changes in alcohol consumption confirmed the cardiovascular advantages of reducing alcohol consumption.

Conclusions

Overall, within the study, heavy drinkers who reduced their alcohol intake showed a significantly lower risk of cardiovascular events over ten years, and marked improvements in health were seen three years after reduction. This reduction in alcohol consumption correlated with a wide selection of cardiovascular advantages, especially in reducing the chance of ischemic stroke and interventions related to angina pectoris. The study elucidates the complex biological mechanisms by which moderate alcohol consumption may protect the cardiovascular system, highlighting improvements in lipid regulation, endothelial function and reduced inflammation. Importantly, the study revealed a marked reduction in the chance of CAD and ischemic stroke amongst heavy drinkers, highlighting the potential health advantages of moderate alcohol consumption.