Alcohol abuse is a risk factor for disease but moderate use may be beneficial. Mechanisms for this contrast remain speculative. Differences may be explained by acute alterations rather than chronic adaptations.

PURPOSE: To compare cardiovascular health markers in patients with and without a history of heavy drinking, and patients who are currently intoxicated.

METHODS: Health outcomes of patients treated at a U.S. hospital were analyzed; 2,033 were sober, 273 tested positive for alcohol, and 131 reported a history of alcohol abuse. Dependent variables were systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), hemoglobin, oximetry, and disease incidence. Independent variables were age, sex, anthropometry, and use of alcohol. Independent-samples t tests and chi-square tests evaluated differences between patients with and without a history of alcohol abuse. Linear and logistic regressions tested the effects of alcohol on dependent variables.

RESULTS: Among sober patients, each year of age predicted 0.3 mmHg higher SBP (p<0.001) but no change in DBP (p=0.137). Across the total sample, current intoxication predicted 8.6 mmHg lower SBP (p<0.001), 8.7 bpm higher HR (p<0.001), and 1.0 g/dL higher hemoglobin (p<0.001). Linear regression found patients who tested positive for alcohol to have 4.6 mmHg lower SBP (p=0.002; 95% CI: -7.6 to -1.6) holding confounders constant. Among sober patients, a history of alcohol abuse associated with an elevated HR (p=0.001), lower pulse pressure (p=0.002), lower oximetry (p=0.018), and a trend for reduced SBP (p=0.056) with no difference in DBP (p=0.404). Linear regression found a history of alcohol abuse to lower pulse pressure (p=0.009) and oxygen saturation (p=0.012) and raise HR (p<0.001). Among sober patients, a history of alcohol abuse did not affect the odds of having a myocardial infarction (p=0.805), congestive heart failure (p=0.712), peripheral vascular disease (p=0.997), stroke (p=0.691), diabetes (p=0.107), or dementia (p=0.905); it did associate with a 15-fold increase in the odds of cirrhosis (p<0.001).

CONCLUSIONS: Sober patients with a history of alcohol abuse mimic the cardiovascular profile of intoxicated patients. This suggests that both short and long-term alcohol ingestion may confer modest cardiovascular benefits.