Perceptions, Information Sources, and Behavior Regarding Alcohol and Heart Health

      Despite the equipoise regarding alcohol's cardiovascular effects and absence of relevant rigorous controlled trials, the lay press frequently portrays alcohol as “heart healthy.” The public perception of alcohol's heart effects, the sources of those perceptions, and how they may affect behavior are unknown. We performed a cross-sectional analysis of data obtained from March 2013 to September 2014 from consecutive participants enrolled in the Health eHeart Study. Of 5,582 participants, 1,707 (30%) viewed alcohol as heart healthy, 2,157 (39%) viewed it as unhealthy, and 1,718 (31%) were unsure. Of those reporting alcohol as heart healthy, 80% cited lay press as a source of their knowledge. After adjustment, older age (odds ratio 1.11), higher education (odds ratio 1.37), higher income (odds ratio 1.07), US residence (odds ratio 1.63), and coronary artery disease (odds ratio 1.51) were associated with perception of alcohol as heart healthy (all p <0.003). Ever smokers (odds ratio 0.76, p = 0.004) and those with heart failure (odds ratio 0.5, p = 0.01) were less likely to cite alcohol as heart healthy. Those perceiving alcohol as heart healthy consumed on average 47% more alcohol on a regular basis (95% confidence interval 27% to 66%, p <0.001). In conclusion, of >5,000 consecutive Health eHeart participants, approximately 1/3 believed alcohol to be heart healthy, and the majority cited the lay press as the origin of that perception. Those with a perception of alcohol as heart healthy drink substantially more alcohol.
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        • Hasin D.S.
        • Stinson F.S.
        • Ogburn E.
        • Grant B.F.
        Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions.
        Arch Gen Psychiatry. 2007; 64: 830-842
        • Gmel G.
        • Rehm J.
        Harmful alcohol use.
        Alcohol Res Health. 2003; 27: 52-62
        • Gunzerath L.
        • Faden V.
        • Zakhari S.
        • Warren K.
        National Institute on Alcohol Abuse and Alcoholism report on moderate drinking.
        Alcohol Clin Exp Res. 2004; 28: 829-847
        • Gaziano J.M.
        • Buring J.E.
        • Breslow J.L.
        • Goldhaber S.Z.
        • Rosner B.
        • VanDenburgh M.
        • Willett W.
        • Hennekens C.H.
        Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction.
        N Engl J Med. 1993; 329: 1829-1834
        • Camargo Jr., C.A.
        • Stampfer M.J.
        • Glynn R.J.
        • Grodstein F.
        • Gaziano J.M.
        • Manson J.E.
        • Buring J.E.
        • Hennekens C.H.
        Moderate alcohol consumption and risk for angina pectoris or myocardial infarction in U.S. male physicians.
        Ann Intern Med. 1997; 126: 372-375
        • Rimm E.B.
        • Giovannucci E.L.
        • Willett W.C.
        • Colditz G.A.
        • Ascherio A.
        • Rosner B.
        • Stampfer M.J.
        Prospective study of alcohol consumption and risk of coronary disease in men.
        Lancet. 1991; 338: 464-468
        • Xin X.
        • He J.
        • Frontini M.G.
        • Ogden L.G.
        • Motsamai O.I.
        • Whelton P.K.
        Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials.
        Hypertension. 2001; 38: 1112-1117
        • Kodama S.
        • Saito K.
        • Tanaka S.
        • Horikawa C.
        • Saito A.
        • Heianza Y.
        • Anasako Y.
        • Nishigaki Y.
        • Yachi Y.
        • Iida K.T.
        • Ohashi Y.
        • Yamada N.
        • Sone H.
        Alcohol consumption and risk of atrial fibrillation: a meta-analysis.
        J Am Coll Cardiol. 2011; 57: 427-436
        • Larsson S.C.
        • Drca N.
        • Wolk A.
        Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis.
        J Am Coll Cardiol. 2014; 64: 281-289
        • Conen D.
        • Tedrow U.B.
        • Cook N.R.
        • Moorthy M.V.
        • Buring J.E.
        • Albert C.M.
        Alcohol consumption and risk of incident atrial fibrillation in women.
        JAMA. 2008; 300: 2489-2496
        • DeNoon D.
        Alcohol may lower risk of heart attack.
        (Available at:) (Accessed on October 13, 2014)
        • Bakalar N.
        Study links alcohol to lower risk of coronaries.
        The New York Times, New York, New York2007
        • McDonald A.
        • Van Horn L.
        • Slattery M.
        • Hilner J.
        • Bragg C.
        • Caan B.
        • Jacobs Jr., D.
        • Liu K.
        • Hubert H.
        • Gernhofer N.
        • Betz E.
        • Havlik D.
        The CARDIA dietary history: development, implementation, and evaluation.
        J Am Diet Assoc. 1991; 91: 1104-1112
        • Dyer A.R.
        • Cutter G.R.
        • Liu K.Q.
        • Armstrong M.A.
        • Friedman G.D.
        • Hughes G.H.
        • Dolce J.J.
        • Raczynski J.
        • Burke G.
        • Manolio T.
        Alcohol intake and blood pressure in young adults: the CARDIA Study.
        J Clin Epidemiol. 1990; 43: 1-13
        • Saunders J.B.
        • Aasland O.G.
        • Babor T.F.
        • de la Fuente J.R.
        • Grant M.
        Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful alcohol Consumption–II.
        Addiction. 1993; 88: 791-804
        • Bohn M.J.
        • Babor T.F.
        • Kranzler H.R.
        The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings.
        J Stud Alcohol. 1995; 56: 423-432
        • Wechsler H.
        • Isaac N.
        ‘Binge’ drinkers at Massachusetts Colleges. Prevalence, drinking style, time trends, and associated problems.
        JAMA. 1992; 267: 2929-2931
        • Kloner R.A.
        • Rezkalla S.H.
        To drink or not to drink? That is the question.
        Circulation. 2007; 116: 1306-1317
        • US Department of Health and Human Services, US Department of Agriculture, US Dietary Guidelines Advisory Committee
        Dietary Guidelines for Americans, 2010.
        7th ed. G.P.O., Washington2010
        • Pearson T.A.
        Alcohol and heart disease.
        Circulation. 1996; 94: 3023-3025
        • Renaud S.
        • de Lorgeril M.
        Wine, alcohol, platelets, and the French paradox for coronary heart disease.
        Lancet. 1992; 339: 1523-1526
        • Yavchitz A.
        • Boutron I.
        • Bafeta A.
        • Marroun I.
        • Charles P.
        • Mantz J.
        • Ravaud P.
        Misrepresentation of randomized controlled trials in press releases and news coverage: a cohort study.
        PLoS Med. 2012; 9: e1001308
        • Lazarevic A.M.
        • Nakatani S.
        • Neskovic A.N.
        • Marinković J.
        • Yasumura Y.
        • Stojicić D.
        • Miyatake K.
        • Bojić M.
        • Popović A.D.
        Early changes in left ventricular function in chronic asymptomatic alcoholics: relation to the duration of heavy drinking.
        J Am Coll Cardiol. 2000; 35: 1599-1606
        • Bryson C.L.
        • Mukamal K.J.
        • Mittleman M.A.
        • Fried L.P.
        • Hirsch C.H.
        • Kitzman D.W.
        • Siscovick D.S.
        The association of alcohol consumption and incident heart failure: the Cardiovascular Health Study.
        J Am Coll Cardiol. 2006; 48: 305-311
        • Djousse L.
        • Gaziano J.M.
        Alcohol consumption and risk of heart failure in the Physicians' Health Study I.
        Circulation. 2007; 115: 34-39
        • Cooper H.A.
        • Exner D.V.
        • Domanski M.J.
        Light-to-moderate alcohol consumption and prognosis in patients with left ventricular systolic dysfunction.
        J Am Coll Cardiol. 2000; 35: 1753-1759
        • Grant B.F.
        • Stinson F.S.
        • Dawson D.A.
        • Chou S.P.
        • Ruan W.J.
        • Pickering R.P.
        Co-occurrence of 12-month alcohol and drug use disorders and personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions.
        Arch Gen Psychiatry. 2004; 61: 361-368
        • Gronbaek M.
        • Johansen D.
        • Becker U.
        • Hein H.O.
        • Schnohr P.
        • Jensen G.
        • Vestbo J.
        • Sørensen T.I.
        Changes in alcohol intake and mortality: a longitudinal population-based study.
        Epidemiology. 2004; 15: 222-228
        • Paulin J.M.
        • Simpson F.O.
        • Waal-Manning H.J.
        Alcohol consumption and blood pressure in a New Zealand community study.
        N Z Med J. 1985; 98: 425-428
        • Leigh B.C.
        Using daily reports to measure drinking and drinking patterns.
        J Subst Abuse. 2000; 12: 51-65

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          Whitman et al1 must be commended from providing simple but strong evidence, from the real-life setting, that promoting alcohol as heart healthy is harmful: The 1/3 of Health eHeart participants who believed alcohol to be heart healthy drank substantially more alcohol than the others and cited the lay press as the origin of that perception. This deserves comment from France, the world's biggest wine producer in 2014.
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