Women, wine and heart disease — Dr. Meredith Maxwell of Touro Hospital and everyone’s favorite wine myth

by

comment
Conventional wisdom says that red wine is heart-healthy, but does science agree? - STEPHAN KRAUSE/CREATIVE COMMONS
  • STEPHAN KRAUSE/CREATIVE COMMONS
  • Conventional wisdom says that red wine is heart-healthy, but does science agree?

The nomenclature can be confusing.

Heart disease, coronary artery disease, cardiovascular disease, atherosclerosis, coronary heart disease — and don’t get started on the acronyms (CAD, CVD, CHD, etc.) — it’s hard to know if you’re sick or eating alphabet soup. Each of these terms refer to a condition that falls under the umbrella of heart disease. Some of these specific diseases are derivatives, or the result of worsening heart disease, but they all point to the same underlying problem, and the same outcome if untreated.

In the 1940s, heart disease was responsible for half of all U.S. deaths, according to the National Institutes of Health (NIH). As of 2014, that number had been reduced to 614,348 deaths — down to about 4 percent of all deaths nationwide. Even though heart disease is often thought of as a “man’s disease,” the truth is that it kills just as many women as it does men. According to the Centers for Disease Control and Prevention (CDC), about 1 in 4 male and female deaths were caused by heart disease in 2013.

Dr. Meredith Maxwell of Touro Hospital has seen the number of female patients with heart disease and resultant complications increase in recent years, a reflection of the national trend. The CDC reports that a woman has a heart attack every 90 seconds, and the NIH reports that more than 75 percent of women ages 40 to 60 have at least one risk factor for heart disease.

A little over 24 percent of all deaths in Louisiana in 2015 were caused by heart disease. - AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION
  • AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION
  • A little over 24 percent of all deaths in Louisiana in 2015 were caused by heart disease.

Risk factors include family history of the disease, poor diet, smoking and obesity. As of a 2015 study, 69 percent of Louisiana adults are obese, and 22 percent are smokers, compared to 65 and 18 percent nationally, according to the American Heart Association (AHA). The AHA also reported that 24 percent of all deaths were caused by heart disease, and that Louisiana has the fifth-highest heart disease mortality rate in the country.

Other diseases like diabetes double the risk of heart disease, Maxwell says.

“Risk factors are individualized,” she says. “You have to make changes to each risk factor for the danger of heart disease, heart attack or stroke to decrease. For example, you can’t exercise regularly, but still smoke.”

Heart disease is typically caused by a buildup of plaque (a hard, waxy substance formed by deposits of fat, cholesterol and calcium) in the coronary arteries. In addition to slowing blood flow, plaque can rupture, causing a blood clot, or even break off and flow to other parts of the body, causing blockages, heart attack, stroke or ischemia (loss of blood flow to and death of body tissues). Ridding the body of plaque buildup, or preventing loosening and traveling of plaque, is essential to avoiding serious complications from heart disease. A regimen as simple as an aspirin a day can reduce chances of significant damage, Maxwell says, because it helps keep plaque from breaking free. But for those truly at risk, an over the counter pill isn’t enough.

“Regular exercise is important,” she says. “You need cardiovascular exercise — an elevated heart rate for at least 30 minutes at a time. Do you need a shower afterward? No? Then you’re not working hard enough.”

Smoking is a major risk factor for heart disease. - 55LANEY69/CREATIVE COMMONS
  • 55LANEY69/CREATIVE COMMONS
  • Smoking is a major risk factor for heart disease.

Maxwell is also a proponent of smoking cessation, a diet rich in fruits and vegetables, restful sleep and managing chronic stress to reduce the risk of heart disease. She asks smokers to question the habit (Why do you enjoy it so much? Is it an escape? An oral fixation? Out of boredom?) to help them quit. Heart disease can be a silent killer. A 2013 CDC study states that 64 percent of women who die suddenly from heart disease had no previous symptoms.

Chest pain that travels down the arm (especially pain that gets worse with activity and better with rest), fatigue, shortness of breath, and gastrointestinal problems like indigestion, nausea or heart burn are symptoms that shouldn’t be overlooked, especially if they occur in tandem. Women may also experience pain in the jaw or neck before a cardiac episode. An abnormal EKG reading (like inverted T-waves) can be simply pathological, indicative of the way the heart regularly functions, or it can be symptomatic of heart disease or an indicator that a heart attack is imminent.

“It has happened that patients come in and have had a heart attack and don’t know it,” Maxwell says.

She is adamant that women — especially women with even one risk factor — see a doctor regularly.

“The most important thing is to see a primary care physician and find risk factors,” she says. “Don’t assume — be proactive. Don’t wait until it happens to you. Intervention is really important. Women must know that they are at risk and why, and what they can do about it.”

She recommends that women see a physician annually, especially after age 30, but she emphasizes that there is no specific age threshold at which women are markedly at higher risk. Heart disease can begin early, even in the teen years, according to the NIH.

“The age is all the time,” she says.

Some research suggests that all alcohol has the ability to reduce LDL, or "bad" cholesterol, and raise HDL ("good" cholesterol), but still others believe red wine has specific benefits due to the antioxidants present in red grapes. - US DEPARTMENT OF AGRICULTURE/CREATIVE COMMONS
  • US DEPARTMENT OF AGRICULTURE/CREATIVE COMMONS
  • Some research suggests that all alcohol has the ability to reduce LDL, or "bad" cholesterol, and raise HDL ("good" cholesterol), but still others believe red wine has specific benefits due to the antioxidants present in red grapes.

Enter our favorite wine myth. It’s been circulating for a while, especially among oenophiles, that a glass of red wine a day is good for your heart. The AHA cites research that shows there is a connection between controlled alcohol consumption (no more than two drinks a day for men and one for women) and reduced mortality due to heart disease, especially with the consumption of red wine. Some researchers believe that there are specific compounds in red wine, such as flavonoids and other antioxidants, that reduce the risk of heart disease, and some believe that ingesting these compounds in non-alcoholic ways — eating red grapes or drinking grape juice, for example — are just as beneficial. Still others believe that drinking red wine alone doesn’t deserve all the credit for mitigating the effects of heart disease, but rather combining that with making other healthy lifestyle choices (balanced diet, regular exercise) work together to reduce mortality.

However, always exercise caution with alcohol. Addiction issues always are possible, and alcohol consumption may exacerbate other health conditions. If there’s even the slightest doubt, consult a physician. The AHA believes that the connection merits further research, but stops short of recommending red wine consumption as an antidote to heart disease risk factors.

Maxwell exercises the same caution when considering the benefits of alcohol.

“It’s not that those who don’t drink should take up drinking,” she says. “But it does seem to lower the risk of heart disease. (Red wine) is full of antioxidants, flavonoids and resveratrol, which raise good cholesterol or HDL [high-density lipoprotein] and reduce damage from LDL [low-density lipoprotein, or “bad” cholesterol]. It also lowers blood pressure, and reduces formation of blood clots.”

The bottom line: eat well, get your rest, exercise regularly and see a doctor at least annually, especially if you think you may be at risk of heart disease. And adding a glass of red wine to that “apple-a-day” adage may be a heart-smart thing to do.


Add a comment