Heart disease rates are increasing among young people in the U.S. In particular, alcohol use and binge drinking have increased among young and middle-aged women.

Alcohol can raise blood pressure and lead to metabolic changes associated with inflammation and obesity, which are both risk factors for heart disease, the lead author of a recent study, Jamal Rana, told TheDoctor.

The study, by Kaiser Permanente researchers, found that heart disease risk is directly associated with alcohol consumption. Women process alcohol differently from men, and the link between alcohol use and heart disease appears to be particularly strong for them.

Heart disease was highest among men and women who reported episodes of heavy drinking, or binge drinking.

“Women may feel they're protected against heart disease until they're older, but this study shows that even when you're young or middle aged, if you are a heavy alcohol user or binge drinker, you are at risk for coronary heart disease,” Rana explained.

The study is among the largest and most diverse to date. It included both men and women and focused on adults between 18 and 65 years old. It used data from more than 430,000 people who received care in the Kaiser Permanente Northern California integrated health organization — nearly 243,000 men and 189,000 women. Participants averaged 44 years of age and did not have heart disease at the start of the 4-year-long study.

Information on the participants' alcohol intake was collected during primary care visits using Kaiser's Alcohol as a Vital Sign screening initiative.

Participants reported if their alcohol intake was low (one to two drinks per week for both men and women); moderate (three to 14 drinks per week for men and three to seven drinks for women); or high (15 or more drinks per week for men and eight or more for women). They also reported whether or not they engaged in binge drinking, which was defined as four or more drinks for men and three or more drinks for women in a single day over the last three months.

Researchers looked at the association between alcohol intake reported over a one-year period and a diagnosis of coronary heart disease over the next four years. More than 3,100 participants developed coronary heart disease during this follow-up period.

Women who reported binge drinking were 68 percent more likely to develop heart disease than those who reported moderate alcohol intake.

Women who reported a high rate of alcohol use had a 45 percent higher risk of heart disease than those who reported low alcohol use and a 29 percent higher rate of heart disease than those who reported moderate consumption.

The risk of heart disease was highest among men and women who reported episodes of heavy drinking, or binge drinking. Women who reported binge drinking were 68 percent more likely to develop heart disease than those who reported moderate alcohol intake. Men who reported high alcohol intake were 33 percent more likely to develop heart disease than those with moderate intake.

For those ready to drink less, the CDC offers these suggestions:

  • Set limits. Decide how many days a week you plan to drink and how many drinks you plan to have. For instance, you might decide to only drink on a Friday night or Saturday night and have one drink. Schedule alcohol-free days every week.
  • Count your drinks. Use an app on your mobile device to help. Understanding how much alcohol counts as a “standard drink” may also help.
  • Identify your triggers. If certain people, places or activities tempt you to drink more than you planned, you can avoid those triggers. For example, instead of a happy hour event with co-workers, suggest catching up at lunch instead. You may also want to remove certain alcohol products from your home.
  • Find support. Ask for support from a friend, family member, healthcare provider or someone else who will support your choice to drink less.

The findings suggest the need for more studies on how alcohol consumption affects heart disease risk, Rana, a cardiologist with the Kaiser Permanente Medical Group, said. He and his team are looking at the best ways for providers to talk to their female patients about alcohol use.

Rana presented the team's research at the annual meeting of the American College of Cardiology on April 6. They plan to submit their work for publication in a peer-reviewed journal. Until then, their results should be considered preliminary.