22 March 2022 In Cardiovascular System

BACKGROUND: Population-based studies generally show J-shaped associations between alcohol intake and mortality from cardiovascular disease (CVD). Little is known about alcohol and long-term mortality risk after myocardial infarction (MI).

OBJECTIVES: We examined alcohol intake in relation to all-cause, CVD, and ischemic heart disease (IHD) mortality in Dutch post-MI patients of the Alpha Omega Cohort.

METHODS: The analysis comprised 4365 patients (60-80 years; 79% male) with an MI 0 to 2 g/d; n = 385), light (M: >2 to 10 g/d; F: >2 to 5 g/d; n = 1125), moderate (M: >10 to 30 g/d; F: >5 to 15 g/d; n = 1207), or heavy drinkers (M: >30 g/d; F: >15 g/d; n = 692). HRs of mortality for alcohol intake were obtained from Cox models, adjusting for age, sex, education, smoking, BMI, physical activity, and dietary factors.

RESULTS: Alcohol was consumed by 83% of males and 61% of females. During approximately 12 years of follow-up, 2035 deaths occurred, of which 903 were from CVD and 558 were from IHD. Compared to the (combined) reference group of nondrinkers and very light drinkers, HRs for all-cause mortality were 0.87 (95% CI, 0.78-0.98), 0.85 (95% CI, 0.75-0.96), and 0.91 (95% CI, 0.79-1.04) for light, moderate, and heavy drinkers, respectively. For CVD mortality, corresponding HRs were 0.80 (95% CI, 0.67-0.96), 0.82 (95% CI, 0.69-0.98), and 0.87 (95% CI, 0.70-1.08) for light, moderate, and heavy drinkers, respectively. Findings for IHD mortality were similar. HRs did not materially change when nondrinkers or very light drinkers were taken as the reference, or after exclusion of former drinkers or patients with diabetes or poor/moderate self-rated health.

CONCLUSIONS: Light and moderate alcohol intakes were inversely associated with mortality risk in stable post-MI patients. These observational findings should be cautiously interpreted in light of the total evidence on alcohol and health. The Alpha Omega Cohort is registered at clinicaltrials.gov as NCT03192410.

26 January 2022 In Cardiovascular System

BACKGROUND: Population-based studies generally show J-shaped associations between alcohol intake and mortality from cardiovascular diseases (CVD). Little is known about alcohol and long-term mortality risk after myocardial infarction (MI).

OBJECTIVE: We examined alcohol intake in relation to all-cause, CVD and ischemic heart disease (IHD) mortality in Dutch post-MI patients of the Alpha Omega Cohort.

DESIGN: The analysis comprised 4,365 patients (60-80 y, 79% male) with an MI 0-2 g/d, n = 385), light (M: >2-10, F: >2-5 g/d, n = 1125), moderate (M: >10-30, F: >5-15 g/d, n = 1207) or heavy drinkers (M: >30, F: >15 g/d, n = 692). Hazard ratios (HRs) of mortality for alcohol intake were obtained from Cox models, adjusting for age, sex, education, smoking, BMI, physical activity and dietary factors.

RESULTS: Alcohol was consumed by 83% of males and 61% of females. During approximately 12 y of follow-up, 2,035 deaths occurred of which 903 from CVD and 558 from IHD. Compared to the (combined) reference group of non-drinkers and very light drinkers, HRs (95% CI) for all-cause mortality were 0.87 (0.78, 0.98), 0.85 (0.75, 0.96) and 0.91 (0.79, 1.04) in consecutive drinking categories. For CVD mortality, corresponding HRs were 0.80 (0.67, 0.96), 0.82 (0.69, 0.98) and 0.87 (0.70, 1.08). Findings for IHD mortality were similar. HRs did not materially change when non-drinkers or very light drinkers were taken as the reference, or after exclusion of former drinkers or patients with diabetes or poor/moderate self-rated health.

CONCLUSION: Light and moderate alcohol intake were inversely associated with mortality risk in stable post-MI patients. These observational findings should be cautiously interpreted in light of the total evidence on alcohol and health.Registration: The Alpha Omega Cohort is registered at Clinicaltrials.gov as NCT03192410.

24 January 2020 In Cardiovascular System

Alcohol has a hormetic physiological behavior that results in either increased or decreased cardiovascular risk depending on the amount consumed, drinking frequency, pattern of consumption, and the outcomes under study or even the type of alcoholic beverage consumed.

However, the vast majority of studies elucidating the role of alcohol in cardiovascular and in the global burden of disease relies on epidemiological studies of associative nature which carry several limitations. This is why the cardiovascular benefits of low-moderate alcohol consumption are being questioned and perhaps might have been overestimated.

Thus, the aim of this review was to critically discuss the current knowledge on the relationship between alcohol intake and cardiovascular disease. Besides new evidence associating low and moderate alcohol consumption with decreased risk of cardiovascular disease, several questions remain unanswered related to the concrete amount of safe consumption, the type of alcoholic beverage, and the age-, sex-, and genetic/ethnical-specific differences in alcohol consumption.

24 June 2019 In Cardiovascular System

BACKGROUND: In addition to its established harmful effects on the liver and other organs, heavy alcohol use confers deleterious effects on the cardiovascular (CV) system, as well. However, data have emerged that light/moderate alcohol consumption (1 drink/day for women and 1-2 drinks/day for men) may be protective against CV disease.

OBJECTIVE/METHODS: English articles regarding the CV effects of alcohol/ethanol were reviewed by search in Medline, Scopus, and Google Scholar.

RESULTS: A J-shaped curve has been proposed to illustrate a differential effect of alcohol on the CV system with the lowest point on the curve (light/moderate drinking) corresponding to optimal exposure to alcohol, which may confer cardioprotection, the rather neutral effect of non-drinking, and the highest risk of heavy and/or binge drinking reflecting the consequence of harmful exposure. However, staying at the nadir of this J-shaped curve appears difficult. Furthermore, concern and distrust have also been raised about the quality of evidence for such "cardioprotection", emphasizing the need for further randomized controlled trials. Another concern relates to the risk of moderate drinking leading to problem drinking, since alcohol is the most common addictive substance.

CONCLUSION: Optimal exposure to alcohol (light/moderate use) means that one needs to stay at the nadir of the J-shaped curve for alcohol use to avail oneself of possible cardioprotection, and this may not be an easy thing to accomplish and/or adhere to, especially if one "likes" alcohol drinking. However, the evidence of "cardioprotection" conferred by alcohol has also been refuted, due to lack of randomized controlled trials.

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