BMJ 1994;308:1003-1006 (16 April)

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Effect of moderate dose of alcohol with evening meal on fibrinolytic factors

H F J Hendriks, J Veenstra, E J M Velthuis-Te Wierik, G Shaafsma, C Kluft 

Organisation for Applied Scientific Research (TNO) Toxicology and Nutrition Institute, PO Box 360,3700 AJ Zeist, Netherlands Organisation for Applied Scientific Research (TNO) Gaubius Laboratory, Institute of Ageing and Vascular Research, Leiden, Netherlands Correspondence to: Dr Hendriks.

Abstract

Objectives : To evaluate the effects of moderate consumption of alcoholic beverages on the fibrinolytic system and to assess whether these effects could help explain the relation between moderate alcohol consumption and reduced coronary heart disease.
Design : Four treatments were allocated in a randomised controlled order on four days over a period of 11 days.
Setting : Metabolic ward of research institute.
Subjects : Eight white healthy middle aged men.
Interventions : Subjects were provided with food for the 11 days. On the four study days mineral water or 40 g of alcohol in the form of beer, wine, or spirits was consumed at dinner early in the evening.
Main outcome measures : Plasminogen activator inhibitor activity, tissue type plasminogen activator antigen, and tissue type plasminogen activator activity one hour before and one, three, five, nine, and 13 hours after dinner with mineral water or alcoholic beverages.
Results : After dinner with alcohol plasminogen activator inhibitor activity rose from 53 (SD 19)% to a maximum of 667 (283%) five hours after dinner (P<0.001). Tissue type plasminogen activator antigen levels rose from 5.3 (2.2) µg/l to a maximum of 10.8 (3.8) µg/l nine hours after dinner with alcohol (P<0.001). Plasminogen activator activity was reduced in the postprandial period (from 1387 (483) IU/l to 323 (288) IU/l five hours after eating; P<0.001) but was higher than normal early the next morning (1516 (809) IU/l after alcohol, 779 (516) IU/l after water; P=0.04).
Conclusion : Moderate alcohol consumption with dinner affects plasminogen activator inhibitor activity, plasminogen activator antigen level, and tissue type plasminogen activator activity temporarily. The effects observed in the early morning are consistent with a decrease in risk of coronary heart disease in moderate drinkers.

Clinical implications

  • Clinical implications

  • Moderate alcohol consumption is associated with a lower risk of coronary heart disease

  • As well as lipoprotein concentrations haemostatic function is an important determinant of coronary heart disease

  • This study shows that moderate alcohol consumption with dinner initially causes a strong increase in plasminogen activator inhibitor activity, and tissue type plasminogen activator antigen levels, which return to normal within 24 hours

  • Tissue type plasminogen activator activity was initially strongly reduced up to nine hours after moderate alcohol consumption with dinner but was higher than normal early in the morning

  • Moderate alcohol consumption seems to have a beneficial effect on the fibrinolytic system


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