Drinking in moderation has been linked with a lower risk of having a heart attack. Now, two new studies show that a drink a day may promote survival in patients after a heart attack, as well as help the elderly steer clear of heart failure.

Alcohol, they explain, has been shown to raise HDL ("good") cholesterol and prevent blood clots from forming.

Despite the findings, the authors point out that heavy drinking can lead to adverse health effects and stress that individuals discuss the risks and benefits of alcohol with their doctors.

In the study, patients who consumed seven drinks a week in the year before their heart attack had a 32% lower risk of dying compared with teetotalers. And those who consumed less than seven drinks a week lowered their risk of dying by 21% over nearly 4 years, compared with patients who abstained from drinking.

The findings suggest that alcohol consumption is probably safe after a heart attack for moderate drinkers. Another study found that elderly people who drank at least 1.5 drinks per day had a risk of heart failure 47% lower than abstainers, regardless of age, race, blood pressure, history of diabetes, smoking and other factors.

The studies do not justify advising lifelong nondrinkers to start drinking for health, especially because most have good reasons for abstinence. However, the studies add important information to the evidence on alcohol and health and should be helpful to clinicians in making individualized, judicious recommendations about alcohol drinking for patients with heart disease.

Journal of the American Medical Association April 18, 2001; 285: 1965-1977