Alcohol consumption, heart disease and all-cause mortality in older adults

Nov 8, 2021

Moderate drinking of alcohol associated with reduced risk of heart disease, ASPREE data reveals


Key points:

  • The association between moderate alcohol consumption and health was largely unknown in older adults
  • This study analysed data from almost 18,000 initially healthy participants in the ASPREE (ASPirin in Reducing Events in the Elderly) trial
  • An alcohol intake of 1-2 standard drinks a day does not seem to increase risk of cardiovascular disease if you’re 70+ and otherwise in good health
  • But there are limitations to this analysis – all participants were healthy at the start of the trial and may have been undertaking other healthy behaviours
  • Findings do NOT suggest that you should start to drink, or increase your alcohol intake, as further research is needed
  • Your GP is the best person to give individual advice about alcohol consumption and your health

A new analysis of ASPREE data by Monash University researchers found that moderate drinking of alcohol is associated with a reduced risk of cardiovascular disease and a lowering of mortality from all causes – when compared to zero alcohol consumption.

The study in 18,000 people in the US and Australia, is the first to look at the heart health implications of alcohol intake in healthy older adults, mostly over the age of 70.

Excess alcohol consumption is a leading contributor to the global burden of disease and a major risk factor for mortality.

Prior studies in middle-aged adults suggested that moderate alcohol consumption may be associated with a lower risk of cardiovascular disease (CVD) events, such as heart attack and stroke.

Above: Dr Johannes Neumann is the lead author of this study, which analysed ASPREE data. 

This analysis, published in the European Journal of Preventive Cardiology, is the first to look at the risk of CVD events and mortality, from all causes, associated with alcohol consumption in initially healthy, older individuals.

Populations around the world are ageing. The Monash University- led ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial was a large-scale, long-term multi-centre, bi-national study of aspirin in healthy older adults.

Dr Johannes Neumann, from the Monash University School of Public Health and Preventive Medicine, led the study into alcohol use in almost 18,000 ASPREE participants – Australians and Americans mostly aged 70 years and older.

Participants in the study did not have prior CVD events, diagnosed dementia or independence-limiting physical disability.

Information on alcohol consumption (days of drinking per week and average standard drinks per day) was assessed by self-reported questionnaire at baseline. The study excluded former alcohol consumers who may have stopped alcohol consumption for various health reasons, possibly introducing bias from reverse causality.

Based on this information, the alcohol intake was calculated as grams per week – for US participants a standard drink was equivalent to 14 g and 10 g for Australian participants.

In the study, alcohol consumption was categorised as 0 (never drinkers) and those who drink 1–50; 51–100; 101–150, and >150g/week. For Australians that is up to 5; 5-10; 10-14 and over 15 standard drinks per week. For Americans – that is up to 3.5; 3.5-7; 7-10 and over 10 standard drinks per week.

Of the almost 18,000 eligible participants with median age 74 years:

  • 57% were female
  • 43.3% were current or former smokers and
  • mean BMI was 28.1 kg/m2

The participants reported that:

  • 18.6% drank no alcohol every week
  • 37.3% reported 1–50 g/week
  • 19.7%reported 51–100 g/week
  • 15.6% reported 101–150 g/week
  • 8.9% reported >150 g/week

Participants were followed for an average of 4.7 years and the study found that there was a reduced risk of CVD events for individuals consuming alcohol of 51–100, 101–150, and >150 g/week, compared to never consuming alcohol, regardless of gender.

Above: ASPREE investigator, Associate Professor Robyn Woods

Consumption of 51–100 g/week was also associated with a reduced risk of all-cause mortality.

Co-author, Associate Professor Robyn Woods says the findings need to be interpreted with caution, as study participants were all initially healthy without prior CVD or other severe diseases, and may have been more physically and socially active than the wider ageing population.

In contrast to alcohol consumption, Dr Neuman says there is clear evidence, that eating well, maintaining a healthy weight, exercise, good blood pressure control, control of lipids and quitting smoking are beneficial for health.

Furthermore, prior evidence showed that excess alcohol consumption increases the risk of other chronic diseases, such as cancer, liver disease or pancreatitis.

In summary, modest alcohol intake in this group of healthy older adults was not harmful for CVD or overall mortality. According to Dr Neumann, further research is warranted to evaluate causal biological effects of alcohol on health and possible behavioural advantages of social drinking and engagement.

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CliniciansAlcohol consumption, heart disease and all-cause mortality in older adults