Are alcohol and hormone replacement therapy good for a woman’s heart? The media continues to publish enticing statements on the purported benefits of drinking alcohol and taking estrogen to prevent heart disease. However, recent research shows that alcohol is toxic to every cell in the human body and hormone replacement therapy may actually increase the risk of heart disease in some women.
Heart disease is the leading cause of death in women in the United States. The most common form of heart disease is hardening of the arteries, or atherosclerosis. This condition results from plaque build-up in your arteries that impedes blood flow and, when severe, results in a heart attack.

Heart disease starts early in life and takes many years to develop. My last column discussed the roles a heart-healthy diet and regular exercise play in the prevention of heart disease in women. Here I hope to give you a better understanding of two of the most controversial issues facing women today regarding their heart health.

Learning of alcohol’s potentially positive effects on your heart may make you feel you have a license to drink “to your health!” However, alcohol may not be the healthiest choice for protecting the health of your heart or the rest of your body. Let’s look at the pros and cons.

The pros: One alcoholic beverage per day for some women and two per day for some men, may help prevent heart disease in some of the women and men. Studies have shown a positive relationship between alcohol consumption and favorable blood fats and clotting factors, which, when unfavorable, are major contributors to the development of hardening of the arteries. However, decreased risk was in men over age 50 and women over age 60. In addition, those who benefited most already had some degree of heart disease. Wine was found to have beneficial effects because it’s rich in flavonoids that can protect arteries from the damage that leads to heart disease.

The cons: Alcohol is a known toxin to the body in any amount. In excess, it can damage liver cells, decreasing their ability to metabolize fats, and it can increase your blood pressure. One study reports that no evidence exists that moderate alcohol consumption in premenopausal women will prevent heart disease. Statistics show that alcohol consumption is highest in women ages 26 to 34 and there’s no data suggesting that alcohol intake in this age group can help prevent heart disease. Also, because of hereditary factors, for some people moderate alcohol consumption can lead to excessive alcohol consumption, a significant contributor to heart disease.

Alcohol can also interfere with immune function. Furthermore, according to the National Council on Alcoholism and Drug Dependence, “The death rate from breast cancer was 30% higher among middle-aged and elderly women reporting at least one drink daily than among non-drinkers.”

The bottom line on alcohol consumption is that women under 60 years of age shouldn’t drink to prevent heart disease; those over 60 who choose to drink should do so in moderation. If you’ve had breast cancer or if you have a strong family history of breast cancer, don’t drink.

Now let’s look at the pros and cons of estrogen’s role in heart health.

The pros: Research shows that estrogen can increase friendly HDL cholesterol that helps prevent heart disease and can decrease unfriendly LDL cholesterol. Women who have had a heart attack shouldn’t take estrogen due to increased risk of stroke; however, women who have had a heart attack and been on estrogen for greater than one year may benefit from estrogen’s help in preventing future attacks.

The cons: Estrogen must be taken long term to prevent heart disease. Unfortunately, the longer you take estrogen, and the higher the dose of the estrogen, the higher your potential risk for breast cancer. Also, a recent study published in the Archives of Internal Medicine reports that estrogen plus progesterone in women who took birth control pills or hormone replacement therapy for more than 5 years could actually increase risk of heart disease. Apparently the hormones damaged artery walls, increasing the risk of plaque formation. The bottom line on estrogen’s role in heart disease prevention isn’t clear-cut; it may help some women and it may increase risk in others.

When you’re making choices regarding alcohol and estrogen, remember that the debate continues. However, what’s indisputable is the role diet and exercise play in preventing heart disease. Starting a healthy lifestyle early in your life is the single most important prescription for protecting your heart.

Article was originally printed in the Honolulu Advertiser, honoluluadvertiser.com