The consultation reports that medical transcription companies provide from physicians’ dictated reports include details of patients’ lifestyle habits, especially alcohol and tobacco consumption. Alcohol-related problems are common in primary care practice and physicians work at changing patients’ drinking behavior before it becomes chronic. When studies reported that “moderate drinking” could protect against cardiovascular disease, many people were elated. However, Medical News Today reports that a recent in-depth review of these studies shows that the benefits on alcohol on health could be misleading.
Moderate alcohol intake is defined as no more than one daily drink for women and no more than two drinks per day for men. Several large prospective studies had found an inverse relationship between moderate drinking and risk of heart attack, ischemic (clot-caused) stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes. For instance, a Japan Collaborative Cohort Study for Evaluation of Cancer Risk in a cohort of 97,432 men and women aged 40-79 over a duration of 10 years found that while heavy drinking increased the risk of all-cause mortality, men and women who consumed less than 23 grams per day of alcohol had a 12%-20% decreased risk of all-cause mortality. An Eastern France study with a cohort of 34,014 men and women followed over a period of 10-15 years reported that those who consumed alcohol in moderation had a 25-30% reduced risk of cardiovascular death. The effect was found to be fairly consistent, corresponding to a 25 percent to 40 percent reduction in risk across many similar studies.
These studies cited scientific and biological evidence to support the association between moderate drinking and protection against heart disease. They claimed that moderate amounts of alcohol appear to raise levels of high-density lipoprotein or “good” cholesterol, which has, in turn, is linked to a lower risk of heart disease. Other beneficial changes include better sensitivity to insulin and improvements in factors that influence blood clotting, thereby protecting against heart attacks and stroke caused by a clot or other blockage within an artery leading to the brain.
The recent review of these existing studies from the Centre for Addictions Research at the University of Victoria in British Columbia, Canada, which was was published in the Journal of Studies on Alcohol and Drugs, questions these findings. The researchers evaluated 45 cohort studies which reported that people who drink moderately enjoyed better health than those who abstain from alcohol. Though the review found an association between moderate drinking and lower risk of heart disease mortality at the time of the study, the results were different when people’s drinking habits at a younger age were considered. The findings of the review are as follows:
- Studies in a cohort aged 55 or younger who were clinically followed into older age found no association with alcohol
- Studies that evaluated participants’ heart health at baseline did not show any benefits from alcohol
- Older “non-drinkers” included in the studies were actually former drinkers who chose to abstain because of poor health
- Healthy seniors who had a glass of wine with dinner are not healthy because they drink, but because they are already in good health
- Non-drinkers were found to be less educated overall – this finding is significant in that good health and longevity are associated with education
The researchers concluded that it was not abstaining from alcohol that led to poorer health. On the other hand, they point out that older “non-drinkers” had quit because their health was already poor and this had misled the results of existing studies.
Management of drinking patients is a common problem that primary care providers face. According to a recent article published in http://www.wbur.org/commonhealth, alcohol is the fourth-leading cause of preventable death in the U.S., killing an estimated 88,000 people a year. The author, a primary care physician, reiterates that counseling about alcohol use and other appropriate interventions can prevent people from getting addicted. As physicians focus on this challenging task, medical transcription service companies will continue to help them ensure consistent care with error-free EHR-integrated documentation solutions.