Modest Wine Drinking May Reduce Risk of Second Heart Attack

Middle-aged French men who drank two or more glasses of wine regularly after a recent heart attack were less likely to have a second heart attack or other cardiovascular complications compared to nondrinkers, according to a study in today's rapid access issue of Circulation: Journal of the American Heart Association.

The study examined data from the Lyon Diet Heart Study, a randomized trial evaluating whether the Mediterranean diet may prevent further cardiovascular disease or death after a first or recent heart attack.

The impact of regular moderate alcohol consumption in patients with heart disease is limited and controversial, says Michel de Lorgeril, M.D., the study's lead researcher, at the Cardiovascular Stress and Associated Pathology Laboratory, at the Joseph Fourier University of Grenoble, France. The Lyon trial offered a unique opportunity to examine the issues in a very homogenous group of French middle-aged male survivors of a recent heart attack.

Researchers evaluated 353 men from the ages of 40 to 60 and classified the amount of alcohol they routinely drank. There were no significant differences in the severity of prior heart attack -- the main indicator of new complications -- in medications used, or in the diet among the drinking ranges.

During a mean follow-up of four years, 104 cardiovascular complications (including recurrent heart attack, stroke and heart failure) occurred. Thirty six of the complications occurred among men who abstained from alcohol; 34 among men who drank less than two glasses of wine a day; 18 among those who drank about two glasses a day, and 16 among men who drank an average of four to five glasses of wine a day. Each glass of wine was about four ounces, says de Lorgeril.

Compared with nondrinkers, men who drank two or more glasses of wine each day reduced their risk for a recurrent heart attack by more than 50 percent compared to nondrinkers.

The inverse relationship between wine drinking and the risk of complication seemed to be independent of the major predictors of cardiovascular disease, including smoking, cholesterol and blood pressure, as well as major lifestyle factors such as dietary habits, says de Lorgeril.

The researchers caution that it's too soon to make general recommendations about secondary prevention. A great deal of prudence is required before extending the results to other groups including women, people younger than 45, those older than 75, or when considering other types of alcohol and drinking patterns, they say. More studies are needed to better define the type of patients who would most benefit from moderate drinking after a heart attack.

Coauthors include Patricia Salen B.Sc.; Jean-Louis Martin, Ph.D.; Francois Boucher, Ph.D.; Francois Paillard, M.D.; and Joel de Leiris, Ph.D.

The American Heart Association recommendations for healthy people state that if you drink, do so in moderation (two drinks a day for men and one drink for women); if you don't drink, don't start; and consult your physician on the benefits and risk of moderate alcohol consumption.