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Alcohol and coronary heart disease: a perspective from the British Regional Heart Study
A G Shaper1, G Wannamethee, M Walker
1Department of Public Health, Royal Free Hospital School of Medicine, London, UK.
Insights
This study suggests alcohol may offer weak protection against coronary heart disease (CHD). However, findings do not encourage regular moderate drinking for health benefits, especially for those without existing cardiovascular issues.
Area of Science:
- Cardiovascular Epidemiology
- Alcohol Consumption Research
- Public Health
Background:
- Previous studies indicate a link between light to moderate alcohol intake and reduced coronary heart disease (CHD) incidence.
- Controversy exists regarding whether this association is a protective effect of alcohol or due to lifestyle factors of non-drinkers.
Purpose of the Study:
- To investigate the relationship between alcohol consumption and cardiovascular morbidity and mortality.
- To clarify the potential protective effects of alcohol on coronary heart disease.
Main Methods:
- Prospective study design involving men aged 40-59.
- Random selection from general practices across 24 British towns.
- Follow-up over 9.5 years for cardiovascular events and mortality.
Main Results:
- A shallow U-shaped relationship observed between alcohol intake and major CHD events; a strong inverse association with fatal CHD events.
- Men with symptomatic CHD showed a strong inverse association between alcohol and CHD events.
- In men without diagnosed cardiovascular disorders, moderate drinking showed a non-significant reduction in CHD death risk but no significant reduction in overall mortality.
Conclusions:
- Findings offer weak support for a protective effect of alcohol on coronary heart disease.
- The study does not recommend regular moderate drinking for health benefits.
Background:
A number of studies have shown that light or moderate alcohol intake is associated with a reduced incidence of coronary heart disease (CHD) compared with non-drinkers. There is controversy as to whether this is due to a specific protective effect of alcohol or whether the increased risk of CHD in non-drinkers is due to selective migration of high-risk subjects from drinking into non-drinking categories.
Methods:
A prospective study of men aged 40-59 years drawn at random from one general practice in each of 24 British towns, and followed for cardiovascular morbidity and all-cause mortality over a 9.5-year period.
Results:
There was a shallow U-shaped relationship between alcohol intake and all major CHD events and a strong inverse association with fatal CHD events. In men with no evidence of CHD at screening, despite a 28% (non-significant) reduction in the relative risk of fatal CHD events in men drinking 2-6 drinks/day, the difference in absolute rates of CHD between the drinking categories was small. Men with symptomatic CHD showed a strong inverse association between alcohol and all major CHD events and fatal CHD events. In men without a doctor diagnosis of cardiovascular disorder, those drinking 2-6 drinks/day showed a 34% (non-significant) reduction in relative risk of CHD death compared to occasional drinkers but little reduction in total cardiovascular mortality and no reduction in all-cause mortality.
Conclusion:
These findings provide weak support for the protective effect of alcohol on CHD and no encouragement for regular moderate drinking on the grounds of benefit to health.