Heavy drinking after suffering a heart attack doubles risk of dying

Heavily drinking – or binging – even intermittently, almost doubles a person’s risk of dying after a heart attack, compared to that of a moderate drinker, according, to a first-of-its-kind study, reported at the American Heart Association’s Scientific Sessions 2004.

Researchers collected data from 1,835 patients in the hospital after their heart attacks. The amount and frequency of alcohol consumption in the year prior to their heart attacks was obtained from patient records and interviews. The researchers asked the heart attack survivors how often they consumed three or more drinks within one to two hours — the study defined this as binge drinking.

Binge drinkers had a 73 percent higher death rate after their heart attacks compared to non-binging patients in the study. Survivors who binged during the year prior to their heart attack were 1.91 times more likely than those who drank moderately to die of any cause — not just cardiovascular disease — in the next several years.

“This is a substantial number, especially because we took into consideration such things as age, diabetes, smoking, exercise and socioeconomic status,” said lead author Kenneth J. Mukamal, M.D., assistant professor of medicine at Harvard Medical School and internist at Beth Israel Deaconess Medical Center in Boston, Mass. “Even taking into account their lifestyles, they had a higher risk of death. Surprisingly, those who binged, but did so less than once a week, had a death rate just as high — 1.93 times that of patients who did not binge. This suggests that even occasional binge drinking has risks, especially in people who have suffered a heart attack.

“The implications are profound. We know that heavy drinking on a regular basis is hazardous for people with or without heart disease. Our research extends that knowledge to episodes of heavy drinking, where even occasionally drinking too much appears to pose a risk to your health.

“Heavy chronic drinking can cause serious health problems, particularly heart ailments and liver damage. It has been much less clear, however, whether intermittent binge episodes have the same risks associated with them,” Mukamal said.

The risk associated with binge drinking appeared similar, whether the person binged on beer, wine, liquor or a combination of alcoholic beverages.

Many studies have looked at the association of alcohol to cardiovascular disease risk but no one had ever investigated the effect of binge drinking on the survival chances of heart attack patients.

“Many of the risks of binge drinking, such as acutely raising blood pressure and changes in the balance of clotting and thinning factors in the blood that can lead to more clots, would be particularly hazardous for somebody who already has heart disease,” Mukamal said.

So the researchers further examined data obtained from patients enrolled at 45 U.S. medical centers in the Determinants of Myocardial Infarction Onset observational study between 1989 and 1994. This study sought to learn what kinds of events and behaviors could trigger a heart attack. Because the team did not see the patients again after their release from the hospital, they tracked deaths by using the National Death Index, compiled by the U.S. National Center for Health Statistics.

Researchers studied 1,279 women and 556 men, average age 62, some of whom were nondrinkers. During the four-year follow-up, 303 died.

Fourteen percent (251) of the patients reported binge drinking within the previous year. These patients were more likely to be smokers and younger (average age 53); 91 percent were male. The patients had double the divorce rate of those in the study who did not binge.

“People who binged once a week also tended to drink a lot. On average, they drank about three drinks a day over the course of a week,” Mukamal said.

“When you realize that most of the binge drinking episodes that occur in America happen among moderate drinkers, it makes our findings more important. People may be getting the message that a glass of wine a day may be good for you. But it is very important to realize that going beyond that one drink a day may totally eliminate any benefit that alcohol may confer.”