Does social drinking protect the heart?

By Dr. W. Gifford Jones

Do you ever feel guilty about having a cocktail after a tough day? Possibly worry that a daily alcoholic drink during the Christmas season is bad for your health? It's prudent to evaluate the medical facts before you decide one way or the other on this matter. And whose decision about the " Happy Hour " makes the most sense for the elderly, the moralists or Sir William Osler?

Dr. Richard Moore Assistant Professor of Medicine at Johns Hopkins University, reports good news. His studies show moderate drinkers have increased levels of apolipoprotein A1. And that this increased level has a protective effect against coronary heart disease (CHD).

I've reported in previous columns that several studies have shown moderate drinkers live longer than teetotalers or heavy drinkers. The protective effect is believed due to an increase in the high density lipoproteins (HDL) which clears the arteries of excess cholesterol. DR. Moore reported to the American Academy of Clinical Pharmacology that it may be that apolipoprotein A1 is more important than HDL.

To determine the effect of alcohol on apolipoprotein he selected 56 males for an eight week study. The lucky half were asked to drink 12 ounces of beer every day. The rest were told to abstain. Apolipoprotein levels increased significantly in drinkers and fell in abstainers.

Dr. Moore admits he's still unsure of the clinical significance of these changes. But reports that two studies of cardiac catheterization patients showing significant differences of coronary occlusion were related to small changes in the amount of apolipoprotein.

Much better news was reported this year in Boston. Dr. Meir Stampfer at Harvard's Brigham and Women's Hospital published results of a study which began in 1976 involving 121,700 female nurses. The nurses were not heavy drinkers with only 7 per cent drinking more than two and a half glasses of wine daily.

The study makes good reading for those who enjoy a sociable drink. The researchers found it didn't matter whether you drank beer, wine or liquor. But drinkers had half the chance of coronary heart disease. In fact, to their surprise, the highest drinkers were found to have the least risk of coronary disease. Dr. Stampfer attributes the decreased risk of CHD to the known effect of alcohol on high density lipoproteins. Other researchers believe that alcohol has an impact on the clotting of blood. That it may help to decrease the level of fibrinogen, one of the factors needed for clotting. And that it also helps to grease the platelets making them less likely to stick together and form a clot.

The debate will continue on the exact mechanism which helps alcohol to lubricate our circulatory system. In the meantime I'm not losing any sleep about having a cocktail at the end of the day. I've never forgotten the sage advice of Sir William Osler, this country's most famous clinician.

Osler remarked many years ago that alcohol is "milk for the elderly." Regrettably this doctor's message hasn't been heard by many nursing and retirement homes for senior citizens . They refuse on moral grounds to allow "The Happy Hour." Yet an alcoholic drink at this time of the day would provide more physical and psychological benefit than the majority of medications these people receive.

I've little doubt beer and liquor companies will continue to use young , attractive people in their ads. I'm not suggesting they stop using this approach. But can't they also give a break to the elderly? The senior citizens who are confined to a single room with little to look forward to day after day. Or others who are confined to wheelchairs and other thousands who are incapacitated one way or another. Would an ad showing a few disabled with crutches sitting together having a "happy hour" ruin a company's image!

I don't think so. Rather, it would be a public service to send a vital message to those who dictate policy at nursing homes. Administrators invariably equate the use of alcohol with irresponsible lifestyle. And they forget that alcohol in moderation is still one of the best medicines available to people of all ages.

I'd also suggest another reason not to neglect the elderly. We have an aging population and it's a sound business decision not to write them off. But if such reasons fall on the deaf ears of company presidents and their ad agencies I've one final reminder. Since aging is a universal malady they too may be sitting in a room looking at four walls before too long. Then they'll have plenty of time to ponder why they never tried to convince well-intentioned, but ill-advised administrators that Sir William Osler was right. And oh how good it would be if they could request a beer, a glass of wine or martini before their Christmas dinner.

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones

Canada Free Press, CFP Editor Judi McLeod