Leslie Cho, MD, an interventional cardiologist who is a professor of medicine at Cleveland Clinic, Ohio. She is director of the clinic’s Women’s Cardiovascular Center.
Could your nightly glass of wine be good for your heart? It’s a popular and widespread idea, driven by the belief that science has found a link between regular drinking and elevated levels of high-density lipoprotein (HDL), the “good” cholesterol. Unfortunately for wine lovers and other drinkers, the story is much more complicated, and the wished-for benefits don’t stand up to scientific scrutiny.
Despite decades of research, studies have never confirmed a cause-and-effect link between lower heart disease rates and moderate drinking, typically defined as no more than a drink or two per day (see sidebar).
While some studies do hint at a benefit, they can’t rule out the possibility that people who drink in moderation have other healthy habits or advantages that protect their hearts. And any theoretical benefit must be weighed against the known health risks of drinking, which include liver disease, cancer, obesity, auto accidents, and falls.
Alcohol also raises blood pressure and, in higher amounts, is clearly linked to increases in stroke and heart disease. Even light drinking is linked with higher risks for some conditions, including some cancers, according to the U.S. Centers for Disease Control and Prevention.
It is true that alcohol raises blood levels of HDL cholesterol. HDL owes its good reputation to the fact that, as it travels through your bloodstream, it sweeps up particles of low-density lipoprotein (LDL), or “bad” cholesterol, and takes them to your liver for disposal. LDLs are harmful bits of waxy fat that can build up on the walls of blood vessels, forming plaques that reduce the flow of blood to and from your heart and other organs, eventually leading to heart attacks and strokes.
But there’s a problem: There’s more than one kind of HDL and those that are linked with drinking don’t seem to be the helpful kind. Instead, they appear to be dysfunctional. They don’t do the LDL cleanup job that HDLs are supposed to do.
Alcohol affects blood fats in other ways, too. Most significantly, it increases levels of triglycerides, a kind of fat linked with stroke, heart attacks, and inflammation of the pancreas. The more you drink, the higher your triglycerides rise. Heavy drinkers see increases in LDL levels as well, also contributing to heart risks.
Bottom line: If you don’t drink, you should not start in a misguided attempt to protect your heart health. If you do drink, it’s important to stay at or below moderate levels.