Study of 18000+ US and Australian older people reveals moderate drinking protective against heart disease, more than for teetotallers

A study by Monash University researchers found that moderate alcohol consumption is associated with a reduced risk of cardiovascular disease and a lowering of mortality from all causes – when compared to zero alcohol consumption.
The study published in the European Journal of Preventive Cardiology, is the first to investigate the risk of CVD events and mortality from all causes, associated with alcohol consumption in initially healthy, older individuals. The Monash University-led ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial was a large-scale, long-term multi-centre, bi-national study of aspirin and health in older adults, with the purpose to discover ways to maintain health, quality of life and independence as people age.
Led by Dr Johannes Neumann, from the Monash University School of Public Health and Preventive Medicine, the study analysed data from almost 18,000 ASPREE participants in Australia and America mostly aged 70 years and older.
Participants in the study did not have prior CVD events, diagnosed dementia or independence-limiting physical disability. CVD events included coronary heart disease death, non-fatal myocardial infarction, fatal and non-fatal stroke, non-coronary cardiac or vascular death, and hospitalisation for heart failure.
Information on alcohol consumption (days of drinking per week and average standard drinks per day) was assessed by a self-reported questionnaire at baseline. The study excluded former alcohol consumers who may have stopped alcohol consumption for various health reasons, possibly introducing bias from reverse causality.
Based on this information, the alcohol intake was calculated as grams per week – for US participants a standard drink was equivalent to 14 g and 10 g for Australian participants. Alcohol consumption was categorised as 0 (never drinkers) and those who drink 1–50; 51–100; 101–150, and >150g/week. For Australians that is up to 5; 5-10; 10-14 and over 15 standard drinks per week. For Americans, that is up to 3.5; 3.5-7; 7-10 and over 10 standard drinks per week.
The participants had a median age of 74 years. 57% were female, 43.3% were current or former smokers and mean BMI was 28.1 kg/m2. 18.6% of participants didn’t drink alcohol, 37.3% consumed 1–50 g/week, 19.7% consumed 51–100 g/week,15.6% consumed 101–150 g/week and 8.9% consumed >150 g/week. They were followed for an average of 4.7 years and the study found that there was a reduced risk of CVD events for individuals consuming alcohol of 51–100, 101–150, and >150 g/week, compared to never consuming alcohol, regardless of gender. Consumption of 51–100 g/week was also associated with a reduced risk of all-cause mortality.
Lead author, Dr Neumann, says the findings need to be interpreted with caution, as study participants were all initially healthy without prior CVD or other severe diseases, and may have been more physically and socially active than the wider ageing population. Furthermore, prior evidence shows that excessive alcohol consumption increases the risk of other chronic diseases, such as cancer, liver disease or pancreatitis.
In summary, modest alcohol intake in this group of healthy older adults was not harmful for CVD or overall mortality. According to Dr Neumann, further research is warranted to evaluate the causal biological effects of alcohol on health and possible behavioural advantages of social drinking and engagement.
Source: Johannes T Neumann, Rosanne Freak-Poli, Suzanne G Orchard, Rory Wolfe, Christopher M Reid, Andrew M Tonkin, Lawrence J Beilin, John J McNeil, Joanne Ryan, Robyn L Woods, Alcohol consumption and risks of cardiovascular disease and all-cause mortality in healthy older adults, European Journal of Preventive Cardiology, 2021;, zwab177. doi.org/10.1093/eurjpc/zwab177