Winnipeg Free Press - PRINT EDITION

Liquor makes heart beat quicker

Puts older adults at risk for form of arrhythmia: study

TORONTO -- Even moderate alcohol consumption may put older adults with heart disease or diabetes at risk of developing a common form of arrhythmia, a new study says.

The work suggests people who are in their 60s or beyond and who have had a heart attack, stroke, have hardening of the arteries or Type 2 diabetes should be careful about how much they drink.

One of the authors admitted Monday this message might be perplexing for people who have been told for years a daily drink or two may be good for heart health.

"It is in a way confusing because if I was 65 or 70, I'm used to having two drinks a day because my doctor says it's good; now this new study says 'You know, maybe it's not so good,' " said Dr. Koon Teo, a professor of medicine at McMaster University in Hamilton.

But based on these findings, Koon, who is a cardiologist, said he would tell patients "two drinks or less may be better than two drinks or more."

The study was published Monday in the Canadian Medical Association Journal.

The findings are drawn from an analysis of data from two large trials designed to study treatment regimens for controlling high blood pressure and congestive heart failure. The studies enrolled a total of more than 30,000 adults in 40 countries. The median age of subjects was 66 and they were followed for 41/2 years on average.

Built into the design of the studies were questions aimed at trying to tease out risk factors for atrial fibrillation, the most common form of arrhythmia. Arrhythmia is a condition in which a sufferer's heartbeat is irregular.

People who suffer from atrial fibrillation often complain of the sensation their heart is racing, or they are dizzy or breathless, even when they aren't exerting themselves. The Canadian Heart and Stroke Foundation estimates about 350,000 Canadians have atrial fibrillation.

The condition puts sufferers at risk of experiencing a stroke. In fact, people with atrial fibrillation are three to five times more likely to have a stroke than people who don't have the condition.

In this study, when moderate and heavy drinkers were compared to people who drank lightly, higher rates of atrial fibrillation were seen.

The researchers used standard measures to classify subjects as low, moderate or high drinkers. Low-level drinkers consume less than a drink a week. Moderate drinkers imbibe between one and 14 drinks a week for women and one to 21 for men. Heavy drinkers consume more than 14 and 21 drinks a week for women and men respectively.

Atrial fibrillation was seen at a rate of about 14.5 cases per 1,000 people per year in low-level drinkers. Among moderate drinkers, that rate rose to 17.3 cases and among heavy drinkers it was 20.5. If the researchers are correct in their conclusions, alcohol consumption may account for the differences in the rates.

The study also suggests binge drinking -- imbibing more than five drinks a day -- was associated with a higher risk of atrial fibrillation.

But Dr. David Juurlink, an internal medicine specialist at Toronto's Sunnybrook Health Sciences Centre, warned there is an important caveat people need to keep in mind in assessing the findings of this type of study, which can only identify associations. It cannot prove the one thing (moderate or heavy drinking) caused another (higher rates of atrial fibrillation), Juurlink said.

Only randomized controlled trials can prove causality. In those studies, people who are similar to each other in age, health status and other factors are divided into two groups. One gets an intervention, the other gets a placebo, and the results are compared.

 

-- The Canadian Press

Republished from the Winnipeg Free Press print edition October 2, 2012 C11

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