23 November 2022 In Cardiovascular System

OBJECTIVES: Many studies have found that moderate alcohol consumption is associated with lower risks of mortality and myocardial infarction (MI). Our aim was to examine the potential effects of alcohol on all-cause mortality and MI in rheumatoid arthritis (RA), a risk factor condition.

METHODS: A cohort study (1995-2017) was conducted using medical records of RA patients from The Health Improvement Network in the United Kingdom (UK). Alcohol exposure was divided into non-drinkers, mild (1-7 UK units/week), moderate (8-14 UK units/week), moderate-high (15-21 UK units/week), and high (>21 UK units/week) consumption levels. We calculated hazard ratios (HRs) for the relation of alcohol consumption to all-cause mortality and MI, adjusting for covariates.

RESULTS: Of 30,320 RA patients, 5,994 deaths and 1,098 MI cases occurred over 236,188 person-years. Mild-to-moderate alcohol use was associated with lower all-cause mortality in RA patients, including those taking methotrexate. The multivariable HRs (95% CI) for mortality by alcohol use category were non-drinkers 1.0, mild 0.80 (0.75-0.85), moderate 0.74 (0.67-0.82), moderate-high 0.84 (0.72-0.98), and high 0.99 (0.86-1.15). Mild, moderate-high, and high levels of alcohol use were associated with lower risk of MI among RA patients. The HRs MI risk by alcohol use category were non-drinkers 1.0, mild 0.81 (0.70-0.94), moderate 0.84 (0.68-1.04), moderate-high 0.51 (0.35-0.74), and high 0.59 (0.42-0.84).

CONCLUSIONS: These findings suggest that mild-to-moderate alcohol use is associated with a lower mortality risk and overall alcohol use is associated with a lower MI risk in RA patients, similar to the general population.

26 August 2022 In Cardiovascular System

BACKGROUND AND AIMS: Alcohol consumption has complex effects on myocardial infarction (MI) and ischemic stroke. We investigated the difference in associations according to drinking patterns (drinking frequency vs. amount per occasion) and sex.

METHODS: This population-based retrospective study included 11,595,191 subjects participating in national health examinations between 2009 and 2010. Using Cox regression analyses, we calculated MI and ischemic stroke risk according to weekly alcohol consumption, drinking frequency, and amount per occasion.

RESULTS: For MI, all weekly alcohol consumption amounts showed lower risk compared to non-drinkers: mild (adjusted hazard ratio [aHR], 0.78; 95% confidence intervals [CI], 0.77-0.79), moderate (aHR, 0.71; 95% CI, 0.70-0.73), and heavy (aHR, 0.74; 95% CI, 0.72-0.76). Drinking frequency and amount per occasion did not differ in MI risk. However, women showed increased risk with heavy drinking and >/=8 drinks per occasion. For ischemic stroke, a J-shaped association was observed for weekly alcohol consumption: mild (aHR, 0.91; 95% CI, 0.90-0.92), moderate (aHR, 0.94; 95% CI, 0.93-0.96), and heavy (aHR, 1.04; 95% CI, 1.02-1.06). Among women, ischemic stroke risk began to increase with moderate drinking. Given similar weekly alcohol consumption levels, ischemic stroke risk increased with higher frequency of drinking, not with amount per occasion.

CONCLUSIONS: Drinking frequency may be a more important risk factor for ischemic stroke than amount per occasion. Among women, the protective effect of alcohol against MI was not evident in heavy amounts, and the risk of ischemic stroke began to increase at lower levels compared to men.

23 November 2020 In Cardiovascular System

Cardiovascular disease (CVD) morbidity and mortality is increasing, representing an important public health issue worldwide. It is well-known that risk of CVD is substantially influenced by lifestyle, including poor diet, tobacco smoking and physical inactivity.

In the last years, the so-called Mediterranean Diet (MedDiet) has been associated with broad healthy benefits on human health, including protection against CVD. The present narrative review aimed to summarize and discuss the evidence from meta-analyses of epidemiological and clinical trials analyzing MedDiet and CVD risk.

The MedDiet is one of the best dietary patterns analyzed in relation to CVD risk and other health outcomes. Studies demonstrated that MedDiet has beneficial effects in the prevention of total and specific types of CVD, albeit a moderate-high degree of inconsistency has been reported and few studies have been included in most of the meta-analyses. As consequence, more high-quality prospective cohorts and randomized clinical trials are warranted in order to increase the confidence in the effect estimates.

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