Association between alcohol consumption and carotid atherosclerosis in Russia

The relationship between alcohol consumption levels and carotid atherosclerosis remains controversial. We investigated this association in 2357 general population participants and 272 in-patients treated for alcohol-related disorders (narcology patients) aged 35-69 years in Arkhangelsk, Russia (Know Your Heart study, 2015-2017). Participants were categorized as non-drinking, non-problem drinking, hazardous drinking, harmful drinking, and narcology patients. Carotid atherosclerosis was assessed via carotid intima-media thickness (CIMT), plaque score (0-6 points), and presence of stenosis ≥ 50%. We used quantile regression for CIMT, linear regression for plaque score, and logistic regression for stenosis. Models were adjusted for sociodemographic factors and dysmetabolic conditions (abdominal obesity, dyslipidemia, hypertension, diabetes, and systemic inflammation). Compared to non-problem drinking, narcology patients had significantly higher CIMT (+ 0.05 mm), plaque score (+ 0.57 points), and odds of stenosis (OR = 2.10) independent of dysmetabolic conditions. Hazardous drinking participants had higher CIMT (+ 0.03 mm) and plaque score (+ 0.15 points), which became non-significant after adjusting for hypertension. Harmful drinking participants did not differ in atherosclerosis markers from those with non-problem drinking. Non-drinking participants had higher CIMT (+ 0.02 mm) and plaque score (+ 0.30 points). These findings in a middle-aged Russian population suggest that chronic severe alcohol consumption can affect carotid artery walls directly, while hazardous drinking is linked to atherosclerosis through hypertensive mechanisms.