Socioeconomically deprived individuals are less likely to consume alcohol than their wealthy counterparts but see higher cardiovascular risks when they do, according to new research out of Norway.

Alcohol’s relationship with heart health can be both beneficial and dangerous, first author Eirik Degerud, of the Norwegian Institute of Public Health, and colleagues wrote in PLOS ONE. While moderate intake of alcohol has been linked to cardiovascular benefits, binge drinking can harm the heart. Degerud et al. wrote in their study the cardiovascular effects of alcohol shouldn’t vary based on class, but might due to an individual’s access to alcohol and tendencies while consuming it.

“Biological effects of alcohol should not differ by socioeconomic position (SEP), but the noncausal associations could do so if the lifestyles that accompany a drinking pattern differ according to SEP,” the authors wrote.

Degerud and colleagues drew a population sample of hundreds of thousands of Norwegian consumers from three national cohorts, according to the study. The team’s analysis was based on self-reported alcohol consumption and binge drinking habits, and together with that information the researchers calculated a patient’s cardiovascular risk with the help of heart rate, triglyceride levels, diabetic status, history of cardiovascular disease, age, gender, smoking status and physical activity levels.

A total 8,435 deaths attributable to heart disease occurred in the average 17 years of follow-up for the study, the researchers reported. Patients who said they were frequent binge drinkers were at the highest risk for death during that period, while moderate consumers were at the lowest risk. People who drank infrequently recorded a higher cardiovascular disease risk than those who drank in moderation.

Predictably, participants in a low SEP were less likely to consume alcohol frequently than middle- or high-class patients, but lower-class individuals experienced significantly more alcohol-related hospitalizations and deaths. They were also more prone to all risk factors for heart disease, the research stated.

“Socioeconomically disadvantaged groups tend to experience more harm from the same level of exposure to alcohol as advantaged groups,” Degerud and co-authors wrote.

These disadvantaged individuals were possibly more likely to co-consume cigarettes or junk food with alcohol, the authors hypothesized, while advantaged participants could be more apt to pair drinking with “advantageous” habits.

“Previous studies have assessed the relationship between SEP and the risk of alcohol-related outcomes, and to various degrees, the mediating role of alcohol consumption,” Degerud et al. said. “Our study appears novel in the sense that it assesses the relationship between alcohol consumption and CVD mortality within strata of life course SEP, which appears to be very sparse or nonexistent in the current literature.”