Perceptions, Information Sources, and Behavior Regarding Alcohol and Heart Health

Abstract

Despite the equipoise regarding alcohol’s cardiovascular effects and absence of relevant rigorous controlled trials, the lay press frequently portrays alcohol as “heart healthy.” The public perception of alcohol’s heart effects, the sources of those perceptions, and how they may affect behavior are unknown. We performed a cross-sectional analysis of data obtained between March, 2013 and September, 2014 from consecutive participants enrolled in the Health eHeart Study. Of 5,582 participants, 1,707 (30%) viewed alcohol as heart healthy, 2,157 (39%) viewed it as unhealthy, and 1,718 (31%) were unsure. Of those reporting alcohol as heart healthy, 80% cited lay press as a source of their knowledge. After adjustment, older age (odds ratio 1.11), higher education (odds ratio, 1.37), higher income (odds ratio 1.07), US residence (odds ratio 1.63) and coronary artery disease (CAD) (odds ratio 1.51) were associated with perception of alcohol as heart healthy (all p < 0.003). Ever smokers (odds ratio 0.76, p = 0.004) and those with heart failure (HF) (odds ratio 0.5, p = 0.01) were less likely to cite alcohol as heart healthy. Those perceiving alcohol as heart healthy consumed on average 47% more alcohol on a regular basis (95% confidence interval 27–66%, p < 0.001). In conclusion, among more than 5,000 consecutive Health eHeart participants, approximately one third believed alcohol to be heart healthy, and the majority cited the lay press as the origin of that perception. Those with a perception of alcohol as heart healthy drink substantially more alcohol.

Alcohol Consumption, Left Atrial Diameter, and Atrial Fibrillation

“…Despite the widely held belief by the public that alcohol has a beneficial effect on general heart health, acute alcohol consumption has long been linked to development of AF . In the Framingham, Copenhagen, and Women's Health Studies, chronic alcohol consumption, especially 2 or more drinks per day, is associated with up to 30% higher risk for incident AF .…”

“…Despite the widely held belief by the public that alcohol has a beneficial effect on general heart health, acute alcohol consumption has long been linked to development of AF. 24 In the Framingham, Copenhagen, and Women's Health Studies, chronic alcohol consumption, especially 2 or more drinks per day, is associated with up to 30% higher risk for incident AF. [1][2][3] Acute alcohol exposure enhances electrophysiologic vulnerability to AF in experimental models, 7 but our understanding of the mechanisms underlying the observed epidemiological associations between alcohol and AF remains incomplete.…”

Alcohol Abuse and Cardiac Disease

“…Conversely, even low to moderate levels of alcohol consumption have been shown to increase the incidence of AF (16–18). Nonetheless, the lay press often highlights the potential health benefits of alcohol consumption (19,20), and the research that promulgates that it is heart healthy to drink more alcohol (21). …”

Alcohol Consumption, Hypertension, and Cardiovascular Health Across the Life Course: There Is No Such Thing as a One‐Size‐Fits‐All Approach

“…As such, public health professionals can quickly be branded as enemies of the people17 for being perceived as trying to push a temperance agenda upon people who are perfectly content with their current level of consumption. Nevertheless, it is clear that a substantial proportion of the population are not fully aware of the risks associated with (even minimal) alcohol consumption,18 and there is evidence that those who believe alcohol confers cardioprotective effects tend to drink more on average than those who do not 19. As such, it is important that the evidence base for alcohol consumption and health continues to be debated in public (including the strengths, limitations, sources of bias, and degree of uncertainty of the collective pool of knowledge).…”