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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Cardiovascular Risk of Alcohol Consumption due to Renal Impairment: A 10-Year Prospective Study in a
Aya Hirata1, Sei Harada1, Miho Iida1
1Department of Preventive Medicine and Public Health, Keio University School of Medicine.
Insights
Alcohol consumption increases cardiovascular disease (CVD) risk, especially with proteinuria. Renal impairment, particularly reduced kidney function, did not significantly alter this association in a large Japanese study.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Alcohol consumption is a known risk factor for cardiovascular disease (CVD).
- The interplay between alcohol intake, CVD risk, and renal impairment is not fully understood.
- Incorporating risk factors into health guidance is crucial for reducing harmful alcohol use.
Purpose of the Study:
- To investigate the association between alcohol consumption and CVD risk in relation to renal status.
- To determine if reduced estimated glomerular filtration rate (eGFR) or proteinuria modifies the alcohol-CVD risk relationship.
Main Methods:
- A 10-year prospective study of 10,583 Japanese adults.
- Alcohol intake categorized into five levels for men and four for women.
- Cox proportional hazards models used to assess CVD risk, stratified by eGFR and proteinuria.
Main Results:
- In men, alcohol intake was linked to higher atherosclerotic CVD risk with proteinuria, but inverse association without proteinuria.
- Moderate to heavy drinking elevated intracerebral hemorrhage risk regardless of renal status.
- In women, increased CVD risk from moderate to heavy drinking occurred only with proteinuria; reduced eGFR showed no clear effect.
Conclusions:
- The cardiovascular disease risk associated with alcohol consumption is significantly influenced by the presence of proteinuria.
- Reduced kidney function (eGFR) did not appear to substantially alter the relationship between alcohol and CVD risk.
Aims:
The association between alcohol consumption and the risk of cardiovascular disease (CVD) varies according to the presence of underlying cardiovascular risk factors. Incorporating such risk factors may be important to effectively reduce harmful alcohol use through health guidance. However, whether the risk of alcohol consumption is affected due to renal impairment remains unclear.
Methods:
A total of 10,583 community-dwelling Japanese adults (mean age 59.4 (SD 10.1) years; 46% men) were followed for 10 years. Alcohol consumption was categorized into five groups for men: never drinkers, former drinkers, light drinkers (＜20 g/day), moderate drinkers (20-39 g/day), and heavy drinkers (≥ 40 g/day), and four groups for women with moderate and heavy combined. Cox proportional hazards models estimated hazard ratios for incident CVD stratified by the presence or absence of reduced estimated glomerular filtration rate (eGFR) (＜60 mL/min/1.73m2) and proteinuria, with adjustment for confounders.
Results:
Among men with proteinuria, alcohol consumption was associated with a higher risk of atherosclerotic CVD, whereas an inverse association was observed in men without proteinuria [hazard ratio (95% confidence interval): moderate drinkers without proteinuria, 0.58 (0.34-0.97); moderate drinkers with proteinuria, 3.49 (1.15-10.56)]. Moderate to heavy drinking increased the risk of intracerebral hemorrhage irrespective of the renal status. In women, moderate to heavy drinking was associated with an increased CVD risk only when proteinuria was present. In contrast, a reduced eGFR did not clearly affect the association in either sex.
Conclusions:
The CVD risk associated with alcohol consumption may differ according to the renal status, particularly depending on the presence or absence of proteinuria.
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