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Impact of alcohol on coronary heart disease in Indian men
A Roy1, D Prabhakaran, P Jeemon
1All India Institute of Medical Sciences, New Delhi, India.
Insights
Moderate alcohol consumption is not protective against coronary heart disease (CHD) in Indian men. This study found alcohol intake was associated with increased CHD risk, contrary to previous findings.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Moderate alcohol consumption is traditionally associated with coronary heart disease (CHD) protection.
- The INTERHEART study indicated alcohol consumption was not protective for CHD in South Asians.
- This study investigated cardiovascular risk factors and CHD prevalence in Indian male alcohol users versus abstainers.
Purpose of the Study:
- To examine the association between alcohol consumption and cardiovascular risk factors.
- To determine the prevalence of coronary heart disease (CHD) in Indian male alcohol users compared to lifetime abstainers.
- To investigate potential gender-specific differences in alcohol's effect on cardiovascular health.
Main Methods:
- A cross-sectional survey was conducted among 4465 employees and family members aged 20-69 in Indian industries.
- Stratified random sampling was used, collecting data on risk factors, alcohol use, and CHD via standardized instruments.
- CHD diagnosis was based on the Rose Questionnaire or physician diagnosis.
Main Results:
- Alcohol users had significantly higher systolic and diastolic blood pressure, and fasting blood sugar compared to abstainers.
- Alcohol users exhibited lower Body Mass Index (BMI), lower total cholesterol, and higher HDL cholesterol.
- After adjusting for tobacco use, BMI, and education, alcohol users showed an increased odds ratio for CHD (OR=1.4), with higher risks for regular and past users.
Conclusions:
- The study did not find a protective association between alcohol intake and CHD prevalence in Indian men.
- Findings suggest alcohol consumption may be associated with increased coronary risk in this population.
- Further large-scale prospective studies are recommended to confirm these findings.
Background:
Moderate alcohol consumption is known to be protective against coronary heart disease (CHD). However, the INTERHEART study, a case-control study of acute myocardial infarction (MI) patients, revealed that alcohol consumption in South Asians was not protective against CHD. We therefore planned to study cardiovascular risk factor and CHD prevalence among male alcohol users as compared to age matched lifetime abstainers.
Methods:
The subjects for this study were recruited from a cross-sectional survey carried out among employees and their family members aged 20-69 years in 10 medium-to-large industries from diverse sites in India, using a stratified random sampling technique. Information on education, behavioral, clinical and biochemical risk factors of CHD and alcohol use was obtained through standardized instruments. CHD diagnosis was based on Rose Questionnaire or a prior physician diagnosed CHD.
Results:
A total of 4465 subjects were present or past alcohol users. The mean age of alcohol users and lifetime abstainers was 42.8+/-11.0 years and 42.8+/-11.1 years, respectively (p=0.90). Systolic blood pressure and diastolic blood pressure were significantly higher in alcohol users (128.7+/-17.6 mmHg/80.1+/-11.3 mmHg) as compared to lifetime abstainers (126.9+/-15.9 mmHg/79.5+/-10.3 mmHg, p<0.01). Fasting blood sugar in alcohol users (98.7+/-30.5 mg%) was also significantly higher than lifetime abstainers (96.6+/-26.0 mg%, p<0.01). Total cholesterol was lower in alcohol users (179.1+/-41.1 mg%) as compared to lifetime abstainers (182.7+/-38.2 mg%, p<0.01). HDL cholesterol was higher in alcohol users (42.9+/-10.8 mg%) as compared to lifetime abstainers (41.3+/-10.0 mg%, p<0.01). Body mass index (BMI) was lower in alcohol users as compared to lifetime abstainers (22.7+/-4.1 kg/m2 vs. 24.0+/-3.3 kg/m2, p<0.001). Tobacco use was significantly higher in alcohol users (63.1% vs. 20.7%). The odds ratio (OR) of having CHD after adjusting for tobacco use, BMI and education was 1.4 (95%CI 1.0-1.9) in alcohol users as compared to controls. The OR was 1.2 (95%CI 0.8-1.6) in occasional alcohol users, 1.6 (95%CI 1.0-2.2) in regular alcohol users and 2.1 (95% CI 1.1-3.0) in past alcohol users as compared to controls.
Conclusion:
We did not observe an inverse (protective) association between alcohol intake and the prevalence of CHD. In contrast, our study indicated an association in the reverse direction, suggesting possible harm of alcohol for coronary risk in Indian men. This relationship needs to be further examined in large, prospective study.
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