Heavy alcohol drinkers needn’t quit completely to protect heart health

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In a new study, researchers found high-risk drinkers who substantially reduce their alcohol use can lower their risk of cardiovascular disease (CDV) despite not completely abstaining.

The research was conducted by a team at Columbia University and elsewhere.

CVD encompasses a range of conditions involving the heart or blood vessels and is the leading cause of death in the US.

It is also one of many negative health outcomes associated with heavy drinking and alcohol use disorder.

Reductions in drinking can be defined using World Health Organization (WHO) ‘risk drinking levels’, which classify drinkers into ‘very high’, ‘high’, ‘moderate’ and ‘low’ risk categories based on their average daily alcohol consumption.

Previous research has shown that a reduction of two or more levels (for example, from ‘very high’ to ‘moderate’) can lower the risk of multiple health issues, but did not assess the impact on CVD specifically.

The current study examined associations between reductions in WHO risk drinking levels and subsequent CVD risk among over one thousand very heavy drinkers in the general US population.

The team focused on people who had a ‘very high’ or ‘high’ (based on average consumption of at least 4.3 standard drinks per day for men, and 2.9 for women) level of alcohol drinking.

Participants were also asked if they had experienced a cardiovascular condition (arteriosclerosis, high blood pressure, angina, tachycardia, or a heart attack) within the previous year.

The team showed that a reduction of two or more WHO risk drinking levels between baseline and follow-up was associated with a much lower risk of CVD at the 3-year time point, compared with drinkers with a less than two-level reduction.

Among those starting from a ‘very high’ risk level (who reduced to moderate or low, or who stopped drinking completely), the odds of CVD were lowered by 40% overall.

Among those at ‘high’ baseline risk (who reduced to low or abstinence), there was a 20% reduction in CVD risk. Including only those who did not reduce to total abstinence made no difference to the findings.

However, the results did differ according to age, such that CVD risk was strongly reduced only among very-high risk drinkers aged over 40, and among high-risk drinkers aged 40 or under.

The findings provide further evidence that drinking reductions are linked to important health benefits for very-heavy drinkers in the US general population.

A goal of drinking reduction without abstinence may help to expand interest in treatment among those most in need.

One author of the study is Deborah S. Hasin.

The study is published in Alcoholism: Clinical and Experimental Research.

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