06 May 2014 In Cardiovascular System

This analysis assesses the 12-month prevalence of coronary heart disease (CHD) in individuals according to their category of alcohol use. The 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions study (the NESARC, n = 43,093) identified 16,147 abstinent individuals, 15,884 moderate consumers, 9,578 hazardous drinkers-defined as exceeding sex-specific weekly limits established by the World Health Organization, and 1,484 alcohol-dependent subjects. Diagnoses were generated using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV version. Both moderate and hazardous drinking were associated with decreased odds of CHD when compared with abstinence, whereas odds of CHD were not significantly different between alcohol-dependent and abstinent participants. A moderate or even a hazardous consumption of alcohol is associated with a decreased likelihood of CHD after controlling for sociodemographic, psychiatric, and addictive risk factors. Our study shows that alcohol may have cardioprotective effects not only in moderate drinkers, but also in individuals with patterns of use traditionally considered as hazardous. (Am J Addict 2011;00:1-7).

06 May 2014 In Cardiovascular System

BACKGROUND: The relationship between alcohol consumption and ischemic stroke or aortic atherosclerosis is unclear, but a protective effect of moderate consumption on stroke risk has been suggested. We conducted a cross-sectional analysis in a population-based sample to evaluate the possible association between alcohol consumption and aortic atherosclerotic plaque (AAP), which is associated with increased stroke risk.

METHODS: As part of the NINDS-funded Aortic Plaques and Risk of Ischemic Stroke (APRIS) study, 464 subjects over the age of 55 were studied (mean age 69.1+/-9.0 with 251 males and 213 females), including 255 patients with first ischemic stroke and 209 stroke-free controls. Transesophageal echocardiogram was performed for the detection of AAP. Alcohol consumption was measured in number of drinks per week during the previous year using a standardized questionnaire, and categorized as: (1) none or minimal (2 daily). Multivariate conditional logistic regression analysis was used to calculate the odds ratios (ORs) and 95% confidence interval (CI) for alcohol consumption and AAP after adjustment for the potential confounding risk factors (age, sex, hypertension, diabetes, dyslipidemia, and cigarette smoking).

RESULTS: Overall, AAP was detected in 326 subjects (70.4%), and 174 subjects (37.6%) had AAP>/=4mm, which carry higher stroke risk. No or minimal alcohol consumption was present in 241 subjects (53.2%), and 177 subjects (39.0%) had light to moderate consumption. Prevalence of light to moderate alcohol consumption was significantly lower in stroke patients than in controls (35.5% vs. 60.3%, p<0.001) and in subjects who had AAP compared with those without it (41.6% vs. 58.8%, p=0.008). After adjusting for significant predictors of atherosclerosis, alcohol consumption of any degree was inversely associated with AAP (OR 0.61; 95% CI 0.37-0.98, p=0.042). The significance of the association was borderline for AAP>/=4mm (OR 0.64, 95% CI 0.41-1.00, p=0.054). In the dose-response analysis, only light to moderate alcohol consumption was significantly associated with a lower risk of having any AAP (adjusted OR 0.45; 95% CI 0.29-0.68, p<0.001) or AAP>/=4mm (adjusted OR 0.51; 95% CI 0.34-0.77, p=0.001).

CONCLUSIONS: Our data indicate that light to moderate alcohol consumption is associated with lower atherosclerotic burden in the proximal aortic arch. This observation may explain at least in part the lower risk of ischemic stroke observed in moderate alcohol consumers.

06 May 2014 In Cardiovascular System

OBJECTIVE: This study examined the frequency and temporal trends of alcohol use among women with and without myocardial infarction (MI) in the United States.

METHOD: We pooled yearly surveys from the nationally representative Behavioral Risk Factor Surveillance System between 1997 and 2008. Subjects for this study were 1,186,951 women, of whom 50,055 had a previous MI. Yearly weighted prevalence rates and frequencies of drinking behaviors were calculated for alcohol use in women with and without previous MI.

RESULTS: Fewer post-MI women consumed alcohol than other women (24% vs. 46%), but the prevalence of drinking increased over time in both groups. Nearly one third of post-MI women and half of all women consumed more than one drink per day. Heavy episodic drinking (four or more drinks per day) increased over time in both groups. After multivariable adjustment, post-MI women were less likely to report any drinking or consuming more than one drink per day, but the prevalence of heavy episodic drinking and the increasing trends over time were similar in both groups.

CONCLUSIONS: Heavy alcohol use and heavy episodic drinking among women in the United States increased over the past decade, regardless of MI history. Although this may have reflected the influence of national guidelines on alcohol consumption, the increase in heavy episodic drinking suggests that better efforts to educate clinicians and women about the harms from excessive alcohol are required.

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