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No amount of alcohol is good for the heart – World Heart Federation

In a policy brief, the World Heart Federation (WHF) based in Switzerland challenges the widespread notion that drinking moderate amounts of alcohol can decrease the risk of heart disease, and calls for urgent and decisive action to tackle the unprecedented rise in alcohol-related death and disability worldwide.

The WHF statement published on 20 January 2022 continues: In 2019, more than 2.4 million people died because of alcohol, accounting for 4.3% of all deaths globally and 12.6% of deaths in men aged 15 to 49.

Alcohol is a psychoactive and harmful substance that can cause significant damage to the human body. Its consumption is a major avoidable risk factor for noncommunicable diseases, including cardiovascular disease, cancer, digestive diseases, and intentional and unintentional injuries, and for several infectious diseases.

The evidence is clear: any level of alcohol consumption can lead to loss of healthy life.

Studies have shown that even small amounts of alcohol can increase a person’s risk of cardiovascular disease, including coronary disease, stroke, heart failure, hypertensive heart disease, cardiomyopathy, atrial fibrillation and aneurysm. Studies that claim otherwise are largely based on purely observational research, which fails to account for other factors, such as pre-existing conditions and a history of alcoholism in those considered to be ‘abstinent’.

To date, no reliable correlation has been found between moderate alcohol consumption and a lower risk of heart disease.

“The portrayal of alcohol as necessary for a vibrant social life has diverted attention from the harms of alcohol use, as have the frequent and widely publicised claims that moderate drinking, such as a glass of red wine a day, can offer protection against cardiovascular disease,” said Monika Arora, a member of the WHF Advocacy Committee and co-author of the brief.

“These claims are at best misinformed and at worst an attempt by the alcohol industry to mislead the public about the danger of their product.”

The economic and social costs of alcohol are also significant: they include the cost to health systems, out of pocket expenditure and productivity losses, as well as the increased risk of violence, homelessness and criminal activity.

Alcohol has a greater impact on people from low socio-economic backgrounds, who are more likely to experience its adverse effects compared to people from higher socio-economic backgrounds, even when consuming similar or lower amounts.

The WHF Policy Brief, “The Impact of Alcohol Consumption on Cardiovascular Health: Myths and Measures”, summarises the available evidence regarding the negative health impacts of alcohol use, explains the alcohol ‘harms versus benefit’ debate, and presents recommendations for both individuals and policy-makers to help counter the deadly impact of alcohol globally.

Cost-effective interventions to reduce alcohol consumption include strengthening restrictions on alcohol availability, enforcing bans on alcohol advertising, and facilitating access to screening and treatment.

 

World Heart Federation policy brief

The Impact of Alcohol Consumption on Cardiovascular Health: Myths and measures

Over the past several decades, the prevalence of cardiovascular diseases (CVD) has nearly doubled, and alcohol has played a major role in the incidence of much of it, says the policy brief executive summary.

Alcohol has also been attributed in deaths due to infectious diseases, intentional and unintentional injuries, digestive diseases, and several other non-communicable diseases, including cancer.

The economic costs of alcohol-associated health outcomes are significant at the individual as well as the country level.

Risks due to alcohol consumption increase for all the major cardiovascular diseases, including hypertensive heart disease, cardiomyopathy, atrial fibrillation and flutter and stroke.

The widespread message for over 30 years from some researchers, the alcohol industry and the media has been to promote the myth that alcohol prolongs life, chiefly by reducing the risk of CVD. Lack of universal advice and stringent policy measures have contributed towards increased uptake and easy availability of alcohol.

The WHO has called for a 10% relative reduction in the per capita use of alcohol between 2013 and 2030. However, lack of investment in proven alcohol control strategies, as well as persistence of misinformation and industry interference, have hindered the efforts of public health professionals to make sufficient progress in reducing alcohol related harms and death.

Introduction

The prevalence of cardiovascular  diseases has nearly doubled  in the last two decades, with more than 500 million cases being reported in 2019 alone. More than 18.5 million individuals have died of CVD, making it the leading cause of global mortality and disability.

Preventable behavioural risk factors play a major role in incidence of CVD, including unhealthy diet, tobacco use, alcohol consumption and low physical activity.

Alcohol is a psychoactive and harmful substance that has become a common accompaniment
of social events in many parts of the world. In addition to being commonly interspersed with the social lifestyles of individuals, the use of alcohol exhibits socio-economic inequity. Individuals with low socio-economic status experience a disproportionately greater alcohol-associated harm than individuals with high socio-economic status from similar or lower amounts of alcohol consumption. Furthermore, when compared by income groups, a higher overall burden of death was observed in lower- and middle-income countries compared to high- income countries.

Alcohol was targeted in the Sustainable Development Goals (SDGs) under SDG 3.5, which calls on countries to “strengthen prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol”.

This inclusion highlighted the role of alcohol as a development obstacle and its close association with many other SDGs and their targets. Alcohol adversely effects 14 out of 17 SDGs and 54 of the targets that make up the 2030 agenda.

With the unprecedented rise in the death and disability from alcohol-attributed CVD and other illnesses, it is imperative for countries and organisations to come together to impart a uniform, evidence-based message and policy agenda for alcohol control.

In a brief survey of members of the World Heart Federation, 44.4% of respondents ‘strongly agreed’ and 5 51.9% of respondents ‘agreed’ that national cardiology foundations/societies should publish guidelines and advocate for domestic policies to address the impact of alcohol on cardiovascular health.

The policy brief summarises the epidemiology and pathophysiology of alcohol use; abridges the alcohol ‘harm versus benefit’ debate; and presents recommendations for strengthening alcohol control globally.

For the full policy brief, see the link below.

 

World Heart Federation statement – No amount of alcohol is good for the heart, says World Heart Federation (Open access)

 

World Heart Federation policy brief – The Impact of Alcohol Consumption on Cardiovascular Health: Myths and measures (Open access)

 

See also from the MedicalBrief archives

 

Moderate alcohol use can be good for the heart if rich, fatal if poor

 

Moderate alcohol use associated with lower CVD risk and all-cause mortality – ASPREE

 

Only alcohol – not caffeine, diet or lack of sleep – might trigger atrial fibrillation

 

Moderate drinking not associated with increased heart or death risk — Large UK analysis

 

 

 

 

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