January 2, 2019 / 6:39 PM / 3 months ago

Seniors with heart failure not harmed by moderate alcohol use

(Reuters Health) - Older people with heart failure may be able to continue drinking moderately without harming their health, a new study suggests.

In fact, heart failure patients who consume up to seven drinks a week may actually live longer than those who completely avoid alcohol, researchers report in JAMA Network Open.

“If you’re 65 and above and have had a diagnosis of heart failure and previously consumed mild to moderate amounts of alcohol, you can probably continue to do so without any harm,” said senior study author Dr. David L. Brown, a professor of medicine at Washington University in St. Louis, Missouri. “And it may actually be associated with some benefit in terms of longevity, although there is no way to show cause and effect from this study. We found that those who continued to consume moderate amounts of alcohol after diagnosis lived almost a year longer than those who never consumed alcohol.”

But, Brown cautioned, “if you have never consumed alcohol, don’t start on the basis of this study.”

Brown got the idea for the study when a patient in the hospital with a new diagnosis of heart failure asked if he could continue to have a cocktail every night.

Heart failure is diagnosed when the organ can’t pump enough blood to the body. There are a host of reasons why this can happen, Brown said, including “having a heart attack that results in loss of heart muscle function, longstanding high blood pressure, obesity, diabetes and even drinking excessive amounts of alcohol.”

To determine whether alcohol should be taken off the menu for heart failure patients, Brown and colleagues looked at health records for nearly 6,000 patients aged 65 and older who signed on to the Cardiovascular Health Study between 1989 and 1993 at four sites in the U.S. In that group were 393 individuals with a new diagnosis of heart failure in the first nine years of follow-up.

Participants with heart failure were followed through June 2013 with regular phone calls. Researchers found that 129 of the heart failure patients continued to drink after they were diagnosed, with most of them consuming the equivalent of one to seven drinks per week.

One drink was equal to 12 ounces of beer, a 6-ounce glass of wine or a 1.5-ounce shot of spirits. Just 17 heart failure patients consumed more than seven drinks a week. Of the 168 patients who abstained from alcohol, just over half were former drinkers and the rest had never been drinkers.

After accounting for factors that could influence heart failure progression, including age, sex, income, smoking history, diabetes and history of heart or kidney disease, researchers found that patients who continued to drink after their heart failure diagnosis lived longer.

On average, the non-drinkers lived 2,640 days after their diagnosis, compared with 3,046 days among those who consumed one to seven drinks a week and 2,806 days among those who consumed more than seven drinks a week.

Why would moderate drinking contribute to a longer life among heart failure patients? “That’s the $64,000 question. We don’t have the answer for that,” Brown said.

“And we still don’t know if alcohol is the primary reason people lived longer,” he added. “It may be that people who drink do it as part of a social network and that is the benefit rather than the alcohol.”

The findings will help doctors counsel heart failure patients who want to know if they can continue to drink, said Dr. Erin Michos of the Ciccarone Center for the Prevention of Heart Disease at the Johns Hopkins School of Medicine in Baltimore, Maryland.

But, Michos noted, the study doesn’t apply to all heart failure patients. “Their study was limited to those who had already survived to at least 65 years . . . and the mean age of these heart failure patients was 79 years; thus their findings cannot necessarily be extrapolated to younger individuals who might have longer life expectancies,” she said in an email.

SOURCE: bit.ly/2Tfd6cU JAMA Network Open, online December 28, 2018.

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