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Category: healthy aging

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This article raises serious questions about the recently published American College of Cardiology and American Heart Association calculators to predict future cardiovascular events (heart attack, strike, etc) which then give recommendations for who needs to take daily statins while they are still healthy. This calculator (ACC/AHA risk calculator) has sparked much debate because many experts believe it overestimates risk. Now a study that looked at untreated people (MESA) showed that the calculator (as well as 3 other calculators) seriously overpredict the chance of a future cardiovascular event. In other words, many, many healthy people told they "may" have a chance of an event in the future are actually not at risk and so statins would not help them, but may harm them. Remember, all medicines have side-effects. Written by cardiac electrophysiologist Dr. John Mandrola (who has his own blog-site www,drjohnm.org) . From Medscape:

Statins in Primary Prevention: Welcome to the Gray Zone

A new study published in the Annals of Internal Medicine confirmed something that ought to be obvious: predicting the future is hard—especially when it comes to cardiovascular events.

We know cardiovascular disease is the number-one killer of humans; we know its first manifestation is often heart attack, stroke, or death; and we know all medical therapy comes with trade-offs. Medical treatment of healthy people in the name of preventing something that may or may not happen in the future is dicey. Think do no harm. That is where risk prediction comes in. You have to know the odds of something (or nothing) happening without treatment. The gamble of statins and aspirin, for instance, looks most favorable in patients who are most likely to have an event.

 But where to draw that line, at what future risk is it worth taking a chemical, is the issue at hand. The extreme cases are easy. Most everyone agrees that statins and aspirin provide enough benefit in patients who have suffered a cardiovascular event. For secondary prevention, future risk is high, so benefits outweigh harms. It's the opposite in very low-risk patients. The middle ground is not so easy.

Here is where we have to consider the tools—calculators—to predict future risk. We know certain conditions, such as age, gender, blood pressure, diabetes, smoking, biomarkers, family history, and coronary calcium, contribute to future risk. Numerous expert panels, including the American College of Cardiology and American Heart Association, have compiled different calculators to predict the future. The ACC/AHA risk calculator for atherosclerotic CVD (ASCVD) has sparked debate because many experts believe it overestimates risk.

Dr Andrew DeFillippis (University of Louisville, KY) and a team of Multi-Ethnic Study of Atherosclerosis (MESA) coinvestigators used this community-based, sex-balanced, multiethnic cohort to compare the calibration and discrimination of the new ASCVD risk score with alternative risk scores.They compared the observed and expected events for the ASCVD score with three Framingham-based scores and the Reynolds risk score in 4227 MESA subjects aged 50 to 74 years over a 10-year follow-up. Using this real-world population, they found four of the five risk scores overestimated risk. Calibration was worse in men: overestimates ranged from 37% to 154%. In women, three of four scores overestimated risk by 46% to 67%, and the Reynolds Risk score underestimated risk by 21%. 

It's worth saying this another way: when the ACC/AHA ASCVD score predicted event rates of 7.5 to 10%—a range deemed above the statin-benefit cutoff—the actual events were just 3%.

Speaking by phone (we live in the same city), lead author Dr DeFillippis explained to me the important business of looking only at untreated patients. He described their sensitivity analysis, which excluded all patients who received aspirin or any lipid-lowering or antihypertensive drug. To lessen the chance of bias, they analyzed this drug-free group of 790 patients separately and found the same overprediction.The authors concluded that if these findings are validated, overestimation of ASCVD risk may have substantial implications for individual patients and the healthcare system.

On that modern theme, Dr DeFillippis made an interesting point to me about the overall best-performing Reynolds Risk score. He noted the Reynolds score uses genetics (family history) and CRP (inflammation) levels to predict the future. Bookmark that for the future—genetics and inflammation, that is.

These findings have major implications. Drugs are not free. Aspirin and statins come with side effects and dollar costs. The patient who takes these drugs in hopes of preventing future events makes the gamble that the costs are worth the benefit. Policy makers who recommend these drugs expose millions of people to a therapy that turns on delicate balance between future benefit and harm.

The final point to make is that the use of statins and other drugs for the prevention of future events is not a doctor's or professional society's decision. The human being who swallows a drug must ultimately decide whether the gamble is favorable.

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I am starting to read more and more negative comments from physicians and researchers about the big pharma and medical society recommendations for treating currently healthy people with statins in the hope it may prevent a cardiovascular event in the future. Many point out that statin health benefits are overstated while negatives and side-effects have been minimized. Many are pointing out that instead of statins, there should be recommendations for lifestyle changes, such as reducing weight, increasing exercise, not smoking, reducing stress, and cutting back on alcohol consumption. After all, these lifestyle changes ONLY have positive effects, and zero negative side effects. From Medical Xpress:

Safety and life-saving efficacy of statins have been exaggerated, says USF scientist

Hailed as miracle drugs when they hit the market two decades ago, statins, the cholesterol-lowering drugs prescribed to prevent heart attacks, are not as effective nor as safe as we have been led to believe, say Dr. David M. Diamond, a professor of psychology, molecular pharmacology and physiology at the University of South Florida, and Dr. Uffe Ravnskov, an independent health researcher and an expert in cholesterol and cardiovascular disease.

According to Diamond and Ravnskov, statins produce a dramatic reduction in cholesterol levels, but they have "failed to substantially improve cardiovascular outcomes." They further state that the many studies touting the efficacy of statins have not only neglected to account for the numerous serious adverse side effects of the drugs, but supporters of statins have used what the authors refer to as "statistical deception" to make inflated claims about their effectiveness.

Their paper is an analysis of the data in the statin trials which led them to conclude that "statin advocates have used statistical deception to create the illusion that statins are 'wonder drugs,' when the reality is that their modest benefits are more than offset by their adverse effects."

The paper also describes how the basis of the deception is in how authors of the statin studies present the rate of beneficial and adverse effects. The effect of the drugs on the population is called the 'absolute risk,' which has shown that statins benefit only about 1% of the population. This means that only one out of 100 people treated with a statin will have one less heart attack. Statin researchers, however, don't present the 1% effect to the public. Instead they transform the 1% effect using another statistic, called the "relative risk," which creates the appearance that statins benefit 30-50% of the population. The exaggeration of beneficial effects of statin treatment was illustrated in their analysis of a subset of statin studies, including the Jupiter Trial (Crestor), the Anglo-Scandinavian Cardiac Outcomes Trial Lipid Lowering Arm (ASCOT-LLA), and the British Heart Protection Study.

"In the Jupiter trial, the public and healthcare workers were informed of a 54 percent reduction in heart attacks, when the actual effect in reduction of coronary events was less than 1 percentage point," said Ravnskov and Diamond.... there were heart attacks and deaths in 3% of the placebo (no treatment) group as compared to 1.9% in the Lipitor group. The improvement in outcome with Lipitor treatment was only 1.1 percentage point, but when this study was presented to the public, the advertisements used the inflated (relative risk) statistic, which transformed the 1.1% effect into a 36% reduction in heart attack risk.

The adverse effects suffered by people taking statins are more common than reported in the media and at medical conferences" explains Diamond and Ravnskov. According to the authors, "Increased rates of cancer, cataracts, diabetes, cognitive impairments and musculoskeletal disorders more than offset the modest cardiovascular benefits of statin treatment."

The authors emphasized that low cholesterol levels related to statin use have frequently been associated with an increased risk of cancer. They also noted that most statin trials are terminated within two to five years, a period too short to see most cancers develop. Nevertheless, studies have shown a greater incidence of cancer in people who take statins, and one long-term study demonstrated a dramatic increase in the incidence of breast cancer among women who had used statins for more than 10 years.

They emphasized that the public needs to be wary of conflicts of interest in the medical community and pharmaceutical industry when it comes to touting the benefits of statins and skewing the data in such a way as to make the drugs seem more effective at lowering cardiovascular disease and heart attack risks than they may actually be.

The authors advocate other health beneficial strategies that are known to reduce cardiovascular risk, such as cessation of smoking, weight control, exercise and stress reduction. They also emphasized the great value of a low carbohydrate diet for normalizing all of the biomarkers of cardiovascular risk, with excellent outcomes, especially for people with type 2 diabetes.

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Once again "conventional medical wisdom" is shown to be wrong. My big question - why has it taken so long to find out what is NORMAL for women?  From NY Times:

Up to 14 Years of Hot Flashes Found in Menopause Study

Conventional wisdom has it that hot flashes, which afflict up to 80 percent of middle-aged women, usually persist for just a few years. But hot flashes can continue for as long as 14 years, and the earlier they begin the longer a woman is likely to suffer, a study published on Monday in JAMA Internal Medicine found.

In a racially, ethnically and geographically diverse group of 1,449 women with frequent hot flashes or night sweats — the largest study to date — the median length of time women endured symptoms was 7.4 years. So while half of the women were affected for less than that time, half had symptoms longer — some for 14 years, researchers reported.

Over all, black and Hispanic women experienced hot flashes for significantly longer periods than white or Asian women. And in a particularly unfair hormonal twist, the researchers found that the earlier hot flashes started, the longer they were likely to continue. Among women who got hot flashes before they stopped menstruating, the hot flashes were likely to continue for years after menopause, longer than for women whose symptoms began only when their periods had stopped.

In this study, only a fifth of cases started after menopause. One in eight women began getting hot flashes while still having regular periods. For two-thirds of women, they began in perimenopause, when periods play hide and seek but have not completely disappeared.

In numerical terms, women who started getting hot flashes when they were still having regular periods or were in early perimenopause experienced symptoms for a median of 11.8 years. About nine of those years occurred after menopause, nearly three times the median of 3.4 years for women whose hot flashes did not start until their periods stopped. Hot flashes, which can seize women many times a day and night — slathering them in sweat, flushing their faces — are linked to drops in estrogen and appear to be regulated by the hypothalamus in the brain.

Researchers found significant differences between ethnic groups. African-Americans reported the longest-lasting symptoms, continuing for a median of 10.1 years — twice the median duration of Asian women’s symptoms. The median for Hispanic women was 8.9 years; for non-Hispanic whites, 6.5 years. Reasons for ethnic differences are unclear. “It could be genetic, diet, reproductive factors, how many children women have,” Dr. Avis said.The study also found that women with longer-lasting symptoms tended to have less education, greater perceived stress, and more depression and anxiety.

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Some weekly strenuous activity is best for women's health. From Science Daily:

Women active a few times weekly have lower risk of heart disease, stroke and blood clots

Middle-aged women physically active a few times per week have lower risks of heart disease, stroke and blood clots than inactive women. More frequent physical activity does not appear to lower the risks further, research shows.

In the study: - Women who performed strenuous physical activity -- enough to cause sweating or a faster heart beat -- two to three times per week were about 20 percent less likely to develop heart disease, strokes or blood clots compared to participants who reported little or no activity. - Among active women, there was little evidence of further risk reductions with more frequent activity. - Physical activities associated with reduced risk included walking, gardening, and cycling.

Participants included 1.1 million women in the United Kingdom with no history of cancer, heart disease, stroke, blood clots, or diabetes who joined the Million Women study in 1996-2001. Their average age when they joined the study was 56. The women reported their level of physical activity at the beginning of the study and three years later. Researchers then examined hospital admissions and deaths in relation to participants' responses. Follow-up was, on average, nine years.

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Nice summary of cancer prevention advice. What it boils down to is that there is no magic bullet for cancer prevention (maybe the closest thing is to NOT smoke), but it's a lot of little things adding up (your lifestyle) that lowers the risk of cancer. From The Washington Post:

Looking for that fruit or vegetable that might prevent cancer?

Blueberries. Green tea. Tomatoes. And, oh, that cruciferous cauliflower. All make the lists of super foods that might help prevent cancer. Then there are the foods such as smoked meat and fried foods that supposedly might cause cancer. Such information is standard fare for TV doctors and Web sites, but most of us don’t know how to judge such claims. What sounds authoritative may not be. Only about half of the recommendations on two internationally syndicated TV medical talk shows were supported by scientific evidence, according to a recent study in the journal BMJ.

Of course, the blueberries we eat today are good for us. But nutrition’s role in cancer prevention is much more complex than a single dietary component: Evidence has mounted, for example, that lifestyle — diet, weight control and exercise — is vital in helping reduce risk. For now, experts endorse general dietary advice that is healthful for a variety of chronic diseases and conditions, rather than reductionist thinking that focuses on single foods or nutrients.

When you hear that a certain food helps prevent cancer, ask: Which cancer? “Cancer is multiple diseases,” said Marian Neuhouser, a nutritional epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle. Whereas cardiovascular disease might be broken down into several types, including myocardial infarction, stroke and peripheral vascular disease, she said, “for cancer, it’s really over 100 different diseases.” “Cancer is a very complex, very challenging disease to study whether you’re looking at it on the cell level or the clinical level or the epidemiologic and preventive level,” Willett said.

Researchers caution about overreacting to a single study. New findings come out every week, but “we never take any one study to be the answer to anything,” said Nancy Potischman, a nutritional epidemiologist at the National Cancer Institute. Only if the same results come up in multiple studies across multiple populations, “then you might think that, yes, this food might be important,” she said.

Tobacco use remains the leading preventable cause of cancer incidence and death worldwide. After tobacco, the lifestyle trio of diet, weight control and exercise may be linked to one-third to two-thirds of cancers. “They’re inseparable,” Neuhouser said. “You can have a great diet and you can have a healthy weight, but if you’re extremely sedentary then there’s a risk.”And there’s a strong link between excess weight and several kinds of cancer, including the esophagus, breast (after menopause), endometrium, colon and rectum, kidney, pancreas, thyroid, gallbladder, according to the NCI. 

Evidence mounts about how lifestyle may affect risk of cancer. In the largest study of its kind, nearly half a million Americans were evaluated for adherence to American Cancer Society cancer prevention guidelines that include smoking avoidance; a healthful, consistent weight; physical activity; limiting alcohol; and a diet emphasizing plants.

Those who followed the guidelines most closely had lowered risk of developing cancer (10 percent for men, 19 percent for women) and dying from cancer (25 percent for men, 24 percent for women) compared with those whose habits were least in line with the guidelines. Most striking was the reduction of overall risk of dying: 26 percent for men, 33 percent for women during the 14-year study period.

Fourteen types of cancer seemed affected by lifestyle behavior, most particularly gallbladder, endometrial, liver and colorectal. For men and women, a healthful weight and physical activity were the top factors in reduced deaths overall. Albert Einstein College of Medicine Researchers published this analysis online in January in the American Journal of Clinical Nutrition, based on data from a National Institutes of Health/AARP study.

Another approach to cancer and nutrition considers dietary patterns. “What we eat on any one day is not going to change our cancer risk, but it’s the pattern over the long term.” Neuhouser said. Several diets that emphasized fruit, vegetables, whole grains and plants or plant-based proteins were analyzed against information collected over more than 12 years from nearly 64,000 post-menopausal women in the Women’s Health Initiative Observational Study. Consuming a high-quality diet was associated with lower death rates from chronic diseases including cancer, as reported last year in the American Journal of Epidemiology.

The bacteria, viruses and other organisms that live in and on humans seem to play a bigger role in health and disease than was previously understood, Freudenheim said. How the countless microbes in such areas as the gut and the mouth might contribute to or prevent cancers is one of the open questions in the new area of study of the microbiome, which refers to the many organisms in the body, 10 percent of which are human and 90 percent nonhuman.

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The researcher who led the study pointed out that millions of people live with and die from cardiovascular disease and that : "Many of these deaths may be prevented by the right lifestyle, including diet." Eating oily fish appears to be part of a healthy lifestyle. From Medical Xpress:

Consuming oily fish could repair damaged blood vessels

Eating oily fish may not only keep your heart healthy but it could actually help to fix damaged blood vessels faster, reducing your risk of cardiovascular disease, University of Reading scientists have found. It is well known that these high in omega-3 fatty acid foods can improve the elasticity of blood vessels and potentially protect against heart disease.

However the reasons for these positive effects are less clear. This study tested two new emerging markers of cardiovascular disease that are of particular interest to researchers in the quest for answers.

The first was endothelial progenitor cells (EPCs), stem cells made in the bone marrow that repair the linings of blood vessels when they become damaged. Previous studies associate a higher number of EPCs with a lower risk of heart disease. Over a period of eight weeks the researchers introduced small amounts (3 g per day) of fish oils to a volunteer group of people with mild risk of cardiovascular risk of a mixed age range. At the end of the eight weeks this study group increased their EPCs numbers by up to 15% compared to a control group.

The second marker, endothelial microparticles (EMPs), are tiny circular vesicles which are shed when the lining of blood vessels is damaged. High numbers of these indicates a high degree of blood vessel damage and are associated with higher risk of heart disease. At the end of the trial, the group consuming the oily fish decreased EMPs by 20% compared to the control group.

"Fish oil is known to increase the release of nitric oxide from the lining of the blood vessel wall which causes relaxation of the vessel and increases blood flow. Our study shows that fish oils could be better for our heart in more ways than previously thought, decreasing damage to the lining of blood vessels and by increasing the numbers of cells which repair those linings.

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Another study that links following the Mediterranean diet with a beneficial health effect - this time a lower risk of ischemic stroke. Unfortunately, it did not seem to lower the risk of hemorrhagic stroke.

The findings were presented at the American Stroke Association's annual meeting. From Medical Xpress:

Mediterranean diet may lower stroke risk, study finds

A Mediterranean diet may reduce your risk of one type of stroke, new research suggests. People who most closely followed the Mediterranean diet were less likely to suffer an ischemic stroke—caused by a blood clot—compared to people with the lowest adherence to the diet, the study found.

A Mediterranean diet includes plenty of fruits and vegetables, whole grains, legumes, nuts, fish, poultry and olive oil. There is limited consumption of red meat, sweets and saturated fats such as those in meat, butter and full-fat dairy products, according to the researchers.

Sherzai's team analyzed data from more than 104,000 teachers in California, averaging 52 years of age, who are taking part in a long-term study. The participants, 90 percent of who were white, were divided into five groups based on how well they followed a Mediterranean diet.

While closely following a Mediterranean diet was associated with a reduced risk of a stroke caused by a blood clot, the healthy eating plan had no effect on a person's odds for a bleeding (hemorrhagic) stroke, according to the study.

According to the researchers, prior research has shown that people who follow a Mediterranean diet have a lower risk of heart disease, mental decline and death, but there is little information about how the diet affects stroke risk.Wright noted that the study was especially rigorous, since the authors accounted for "other factors that would reduce stroke risks, such as exercise, total caloric intake,body mass index, smoking and menopausal/hormonal status."

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Another positive thing we can do for our brains - meditation.From Science Daily:

Forever young: Meditation might slow the age-related loss of gray matter in the brain

Since 1970, life expectancy around the world has risen dramatically, with people living more than 10 years longer. That's the good news.The bad news is that starting when people are in their mid-to-late-20s, the brain begins to wither -- its volume and weight begin to decrease. As this occurs, the brain can begin to lose some of its functional abilities.

Building on their earlier work that suggested people who meditate have less age-related atrophy in the brain's white matter, a new study by UCLA researchers found that meditation appeared to help preserve the brain's gray matter, the tissue that contains neurons.

The scientists looked specifically at the association between age and gray matter. They compared 50 people who had mediated for years and 50 who didn't. People in both groups showed a loss of gray matter as they aged. But the researchers found among those who meditated, the volume of gray matter did not decline as much as it did among those who didn't.

Dr. Florian Kurth, a co-author of the study and postdoctoral fellow at the UCLA Brain Mapping Center, said the researchers were surprised by the magnitude of the difference."We expected rather small and distinct effects located in some of the regions that had previously been associated with meditating," he said. "Instead, what we actually observed was a widespread effect of meditation that encompassed regions throughout the entire brain."

As baby boomers have aged and the elderly population has grown, the incidence of cognitive decline and dementia has increased substantially as the brain ages.

Each group in the study was made up of 28 men and 22 women ranging in age from 24 to 77. Those who meditated had been doing so for four to 46 years, with an average of 20 years.

The participants' brains were scanned using high-resolution magnetic resonance imaging. Although the researchers found a negative correlation between gray matter and age in both groups of people -- suggesting a loss of brain tissue with increasing age -- they also found that large parts of the gray matter in the brains of those who meditated seemed to be better preserved, Kurth said.

The researchers cautioned that they cannot draw a direct, causal connection between meditation and preserving gray matter in the brain. Too many other factors may come into play, including lifestyle choices, personality traits, and genetic brain differences.

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Interesting that less is best when it comes to jogging and health. Found U shaped association in health benefits from jogging: "Joggers who ran 1 to 2.4 hours per week had the lowest risk of mortality, with a significant 71% lower risk of death than sedentary nonjoggers. And in fact, the people who jogged the most frequently and at the fastest pace — who were, in effect, runners rather than joggers — did not enjoy much benefit in terms of mortality. In fact, their lifespans tended to be about the same as among people who did not exercise at all." From NY Times:

Slow Runners Come Out Ahead

The ideal amount of running for someone who wants to live a long and healthy life is less than most of us might expect, according to a new study, which also suggests that people can overdo strenuous exercise and potentially shorten their lives.

There is increasing consensus among physicians and exercise scientists that people should exercise intensely at least sometimes. Past studies have found, for instance, that walkers who move at a brisk pace tend to live longer than those who stroll, even if they cover about the same distance.

So for the new study, which was published this month in The Journal of the American College of Cardiology, the researchers, most of them affiliated with the University of Copenhagen, turned to the enormous database about health habits among Danes known as the Copenhagen City Heart Study. In this case, instead of focusing on cycling, the researchers decided to look at jogging, since it is the most popular strenuous activity worldwide.

The researchers culled data for 1,098 adult men and women of varying ages who, upon their entry into the study in 2001, had identified themselves as joggers. They also had provided information about how often they ran per week, at what pace, and for how long. The researchers also pulled records for 3,950 age-matched volunteers who had said in 2001 that they did not engage in any type of vigorous exercise or, in fact, any exercise at all. All of the volunteers were generally healthy, however, without evidence at the time of disease or obesity.

As it turned out, and as expected, joggers consistently tended to live longer than people who did not exercise. But when the researchers closely parsed the data about how much and how intensely people jogged, some surprises emerged. The ideal amount of jogging for prolonged life, this nuanced analysis showed, was between 1 hour and 2.4 hours each week. And the ideal pace was slow. 

Plodding joggers tended to live longer than those who were faster. And in fact, the people who jogged the most frequently and at the fastest pace — who were, in effect, runners rather than joggers — did not enjoy much benefit in terms of mortality. In fact, their lifespans tended to be about the same as among people who did not exercise at all. The results suggest that the “optimal dose of jogging is light, and strenuous joggers and sedentary non-joggers have similar mortality rates,” said Jacob Louis Marott, a researcher for the Copenhagen City Heart Study and co-author of the study.

More details and discussion are in the Medscape article.From Medscape:

Short, Easy—Not Strenuous—Jogging Gives Biggest Survival Gain: Analysis

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It's interesting how drinking alcohol seems to have a J-curve for health effects. Light drinkers seem to do the best, but heavy drinkers do the worst of all groups (also see earlier posts). This research (published this week in the journal Stroke) shows that drinking more than 2 drinks a day in middle age is a bigger risk factor (double the risk) for a stroke between the ages of 60 to 75 years than high blood pressure, diabetes, or genetics. And once again, looking at the study one can see that nondrinkers had a small increased risk for stroke vs very light drinkers. From Science Daily:

Heavy drinking in middle-age may increase stroke risk more than traditional factors

Drinking more than two alcoholic beverages a day in middle-age raised stroke risks more than traditional factors such as high blood pressure and diabetes. Heavy drinking in mid-life was linked to having a stroke about five years earlier in life irrespective of genetic and early-life factors.

In a study of 11,644 middle-aged Swedish twins who were followed for 43 years, researchers compared the effects of an average of more than two drinks daily ("heavy drinking") to less than half a drink daily ("light drinking").

The study showed that: - Heavy drinkers had about a 34 percent higher risk of stroke compared to light drinkers. - Mid-life heavy drinkers (in their 50s and 60s) were likely to have a stroke five years earlier in life irrespective of genetic and early-life factors. - Heavy drinkers had increased stroke risk in their mid-life compared to well-known risk factors like high blood pressure and diabetes. - At around age 75, blood pressure and diabetes appeared to take over as one of the main influences on having a stroke.

Researchers analyzed results from the Swedish Twin Registry of same-sex twins who answered questionnaires in 1967-70. All twins were under age 60 at the start. By 2010, the registry yielded 43 years of follow-up, including hospital discharge and cause of death data. ... Almost 30 percent of participants had a stroke. They were categorized as light, moderate, heavy or non-drinkers based on the questionnaires. 

Among identical twin pairs, siblings who had a stroke drank more than their siblings who hadn't had a stroke, suggesting that mid-life drinking raises stroke risks regardless of genetics and early lifestyle.

The study is consistent with the American Heart Association's recommended limit of two drinks a day for men and one for women. That's about 8 ounces of wine (two drinks) for a man and 4 ounces (one drink) for a woman. Regular heavy drinking of any kind of alcohol can raise blood pressure and cause heart failure or irregular heartbeats over time with repeated drinking, in addition to stroke and other risks.