Is red wine really good for our heart?

We hear a lot of mixed messages about alcohol – some say red wine is good for the heart. Yet, we know alcohol is also a leading cause of premature deaths. Cardiologist Dr Paddy Barrett sets the record straight. 

Let’s look at the bad news first. Alcohol has the potential to cause significant harm. Globally, it is responsible for 3 million deaths per year, and in the United States alcohol is the third leading cause of preventable death. Alcohol consumption is associated with a range of cardiovascular risks including high blood pressure, high triglycerides, coronary artery disease, metabolic syndrome and poor sleep.

We also know that once your intake goes above two drinks per day the risks start to increase rapidly. Alcohol has been associated with several cancers and liver, lung and bone disease.

Alcohol and heart health

For many years the research suggested that although large amounts of daily alcohol were likely to be harmful, moderate amounts of alcohol, typically defined as less than two to four drinks per day, were considered beneficial. In this moderate alcohol consumption group, people tended to live longer on average. This was also compared to people who consumed no alcohol daily.

The reason the people drinking moderate amounts of alcohol tended to live longer was down to an issue called the “healthy user bias”. Longer-term research on alcohol was based on observational data, meaning those in the trial were not randomly assigned to either an alcohol or a no-alcohol group. This means that in addition to whether or not a person consumed alcohol, there were many other factors at play, including other risk factors, such as smoking, high blood pressure, or inactivity, that might explain any difference between the two groups. So, these people were healthier, but not solely due to their alcohol consumption.

More recent research has done a much better job of controlling for these other variables, and the results are clear: any alcohol is likely to be bad for your cardiovascular health, and the more alcohol you consume, the higher the risk. If your goal is to reduce your risk of heart disease, then the answer is to not drink alcohol.

Of course, we all take risks every day of our lives. Every time we drive our car, we risk death or serious injury. The question we must always ask is if that risk is worth it. If you enjoy an occasional glass of wine with friends, and have low risk factors elsewhere, then you might think it’s worth it.

But what about resveratrol?

Research on a compound called resveratrol, commonly found in the grape skins used to produce red wine, suggested that it had the potential to reduce cholesterol levels. This is where the story of red wine being “good for you” came from. However, you would need to drink several litres of wine a day to consume enough resveratrol to lower cholesterol, which would not be good for your health.

Heart: An Owner’s Guide by Dr Paddy Barrett is out now (DK, £15)

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