October 21, 2018
Does Alcohol Harm Older Hearts?
Ask the Experts

Does Alcohol Harm Older Hearts?

by Berkeley Wellness  

Q: I read about a study showing that even moderate alcohol intake can damage older people’s hearts. Does this mean that people over 65 shouldn’t drink?

A: Not necessarily. Whether to drink alcohol is a personal decision with pros and cons—at any age. Most people over 65 needn’t avoid alcohol, though some should abstain for health reasons, and many should probably drink less than what’s gener­ally considered moderate (two drinks a day for men and one drink for women).

The study you mention, published in Circula­tion: Cardiovascular Imaging, doesn’t change this advice. It correlated alcohol consumption with heart structure and function (as seen via echocardiograms) in nearly 4,500 people, average age 76. Even moderate alcohol con­sumption was found to be associated with adverse effects on the heart, especially in women; the effects were quite subtle, how­ever, and are unlikely to be clinically meaning­ful. It’s well known that very heavy drinking can damage the heart muscle, but relatively few people in the study were heavy drinkers.

Alcohol has a reputation for being heart-healthy because it helps prevent heart attacks by reducing blood clotting and raising HDL (“good”) cholesterol. Older people are at high­est risk for heart disease and are thus likely to benefit most. But only small amounts of alco­hol are needed to achieve those effects. Light to moderate intakes have other potential benefits, such as reducing age-related bone loss and cognitive decline.

Older people need to be cautious with alcohol because of changes that occur with aging. Notably, their bodies don’t process alco­hol as well as they used to, so they end up with higher blood levels and more adverse effects. Women don’t process alcohol as well as men, so older women need to be doubly cautious.

What’s more, older people often take mul­tiple medications, and alcohol interacts with many of them; this can increase physical and cognitive impairment as well as cause serious reactions. The risks are amplified because drugs tend to stay longer in older bodies, as does alcohol, increasing the likelihood of interactions.

Finally, most older people have hyperten­sion, and alcohol can increase blood pressure.

The National Institute on Alcohol Abuse and Alcoholism recommends that healthy older people average no more than one drink a day and that those who take certain medica­tions drink less or not at all. That’s good gen­eral advice, though for some healthy older men two drinks a day are okay, while for many unhealthy people even one drink is too much. If you’re over 65, it’s best to discuss your drink­ing habits with your health care provider.

For more on the benefits and risks of alco­hol, see Alcohol: What Moderation Means.