Moderate alcohol consumption is associated with better endothelial function: a cross sectional study
BACKGROUND: Moderate alcohol consumption is protective against coronary artery disease. Endothelial dysfunction contributes to atherosclerosis and the pathogenesis of cardiovascular disease. The effects of alcohol consumption on endothelial function may be relevant to these cardiovascular outcomes, but very few studies have examined the effect of alcohol consumption on endothelial function assessed by flow-mediated dilation (FMD) of the brachial artery in humans.
METHODS: In the population-based Northern Manhattan Study (NOMAS), we performed a cross-sectional analysis of lifetime alcohol intake and brachial artery FMD during reactive hyperemia using high-resolution B-mode ultrasound images among 884 stroke-free participants (mean age 66.8 years, women 56.6%, Hispanic 67.4%, black 17.4%, and white 15.2%).
RESULTS: The mean brachial FMD was 5.7% and the median was 5.5%. Compared to non-drinkers, those who drank >1 drink/month to 2 drinks/day were more likely to have FMD above the median FMD (5.5%) (unadjusted OR 1.7, 95% CI 1.2-2.4, p = 0.005). In multivariate analysis, the relationship between moderate alcohol consumption and FMD remained significant after adjusting for multiple traditional cardiovascular risk factors, including sex, race-ethnicity, body mass index, diabetes mellitus, coronary artery disease, Framingham risk score, medication use (adjusted OR 1.8, 95%CI 1.1-3.0, p = 0.03). No beneficial effect on FMD was seen for those who drank more than 2 drinks/day.
CONCLUSION: In conclusion, consumption of up to 2 alcoholic beverages per day was independently associated with better FMD compared to no alcohol consumption in this multiethnic population. This effect on FMD may represent an important mechanism in explaining the protective effect of alcohol intake on cardiovascular disease.
AIMS: To assess the association between drinking patterns and mortality, and cardiovascular disease in a large cohort of young- and middle-aged men and to assess whether the net balance of harm and protective effect implies protective effect or not.
METHODS: Information from health examinations, psychological assessments and alcohol use background in a nationally representative birth cohort of 49,411 male military conscripts aged 18-20 years in 1969/1970, were linked to mortality and hospitalization data through 2004. Cox regression analyses were conducted and attributable proportions (APs) calculated. Confounders (baseline social status, intelligence, personality and smoking) were taken into account.
RESULTS: Increasing alcohol use was associated with increasing mortality (2614 deceased) and with decreasing risk for myocardial infarction (MI). The hazard ratio (HR) for mortality was 1.42 [95% confidence interval (CI) 1.10-1.82] with a consumption corresponding to 30 g 100% ethanol/day or more in multivariate analysis. The risk for non-fatal MI was significantly reduced at 60 g 100% ethanol/day (HR 0.37, 95% CI 0.15-0.90), not reduced for fatal MI, and non-significantly reduced for total MI. There was a marked association between alcohol use at conscription and mortality and hospitalization with alcohol-related diagnosis. APs indicate that alcohol caused 420 deaths, 61 cases of non-fatal stroke and protected from 154 cases on non-fatal MI.
CONCLUSION: Many more deaths were caused by alcohol than cases of non-fatal MI prevented. From a strict health perspective, we find no support for alcohol use in men below 55 years.
BACKGROUND: Although moderate alcohol intake is associated with lower risk for myocardial infarction (MI), guidelines generally suggest that adults seek other lifestyle measures to reduce cardiovascular risk. We studied whether alcohol consumption is inversely associated with risk for coronary heart disease in men who report consistently favorable lifestyle behaviors.
METHODS: From 51 529 male participants of the Health Professionals Follow-up Study who have reported diet and other lifestyle factors in biennial questionnaires since 1986, we defined a cohort of 8867 men free of major illness to participate in a prospective study. All participants reported 4 healthy lifestyle behaviors, including a body mass index (calculated as weight in kilograms divided by height in meters squared) of less than 25, moderate to vigorous activity for 30 minutes or more per day, abstention from smoking, and a summary diet score in the top 50% for men. High dietary scores reflected a high intake of vegetables, fruits, cereal fiber, fish, chicken, nuts, soy, and polyunsaturated fat; low consumption of trans-fat, and red and processed meats; and multivitamin use. We ascertained the incidence of nonfatal MI and fatal coronary heart disease according to reported intake of beer, wine, and liquor every 4 years.
RESULTS: During 16 years of follow-up, we documented 106 incident cases of MI. Compared with abstention, the hazard ratios for MI were 0.98 (95% confidence interval, 0.55-1.74) for alcohol intake of 0.1 to 4.9 g/d, 0.59 (95% confidence interval, 0.33-1.07) for alcohol intake of 5.0 to 14.9 g/d, 0.38 (95% confidence interval, 0.16-0.89) for alcohol intake of 15.0 to 29.9 g/d, and 0.86 (95% confidence interval, 0.36-2.05) for alcohol intake of 30.0 g/d or more. In men who met 3 criteria, the lower risk associated with alcohol intake of 5.0 to 29.9 g/d tended to be similar to the lower risk associated with the remaining healthy lifestyle behavior.
CONCLUSION: Even in men already at low risk on the basis of body mass index, physical activity, smoking, and diet, moderate alcohol intake is associated with lower risk for MI.
BACKGROUND: Individual-level studies indicate the possibility of both protective and harmful effects of alcohol consumption on Ischemic Heart Disease (IHD) mortality depending on the pattern of consumption. Population-level relationships could be in either direction and previous studies have found mixed results.
METHODS: Population-level relationships between IHD mortality rates and per capita consumption of alcoholic beverages, cirrhosis mortality rates, cigarettes, and sugar sweetened soda for the period from 1950 to 2002 are modeled using autoregressive integrated moving average (ARIMA) and vector error correction methods.
RESULTS: In multivariate ARIMA models controlling for accumulated heavy drinking as represented by cirrhosis mortality, a protective effect of 4%/l was found for total alcohol consumption while cirrhosis mortality rates had significant positive effects on IHD rates. Beverage-specific models found no effect for wine, positive risks for spirits, and significant protective effects for beer. The protective effects for both total alcohol and beer were also found in vector error correction models. Significant positive effects of cigarette sales on IHD rates were also found in both types of models.
CONCLUSIONS: The complexity of alcohol's relationship with IHD is highlighted. Aspects of pattern represented by beverage-specific consumption and cirrhosis mortality indicate potential protective effects from moderate drinking and harmful effects from heavy drinking in accord with individual-level findings.