Moderate and regular drinkers have a lower risk of heart disease

Title: Association of longitudinal alcohol trajectories with coronary heart disease: a meta-analysis of six cohorts using individual participant data
Journal:
Dara O'Neill et al
Published: 2018/8/22
Digital Identification Number: 10.118 6/s12916-0118-1123-6
Link:
's most recent study of 35,132 people, published in
, found that irregular drinking increases the risk of cardiovascular disease, butfound that a team led by University College London and the University of Cambridge found that Over a 10-year period, moderate but irregular drinkers, former alcoholics who had been drinking but had quit drinking and self-reported never-drinking had a higher risk of coronary heart disease than those who followed the UK's moderate drinking guidelines, although non-drinkers who followed the rule were limited to women.
Dr Dara O'Neill, co-author of the study from University College London, said: "Our study used long-term tracking data to distinguish between people who had never been drinking and those who had been drinking but had given up alcohol - according to the widely accepted theory that the latter should have a higher risk of coronary heart disease than the former, and we wanted to use the data to see if that was the case. The final results do confirm this conclusion, but we find that there is a gender difference in this theory. Women who never drank had a higher risk of coronary heart disease than regular moderate drinkers, but men who never drank did not. Overall
, 1,718 (4.9 per cent) of the 35,132 people included in the six queue studies developed coronary heart disease during the study period, of whom 325 (0.9 per cent) were seriously ill. The incidence of coronary heart disease was highest among those who had been drinking but had given up alcohol, reaching 6.1 per cent, of which 1.2 per cent were serious cases, and among regular heavy drinkers, 3.8 per cent were severe, of which 0.6 per cent were serious cases. The authors caution that the incidence of coronary heart disease among heavy drinkers is highly questionable because fewer heavy drinkers, especially women, are involved in the study.Dr O'Neill,
O'Neill, said: "In population-level studies, the sample size of heavy drinkers is often insufficient, so while our study shows that the incidence of coronary heart disease in heavy drinkers is not high, the results must be interpreted with great care, after all, we already know that heavy alcohol intake causes a lot of health problems. The
study suggests that long-term and unstable drinking behaviors may pose a risk of coronary heart disease. This may be because unstable drinking behaviors often reflect more lifestyle instability, including poor health or stress, the authors say.
lifestyle may also be related to differences in risk between age groups observed by the researchers.
O'Neill said: "When we grouped the sample population by age, we found that the increased risk of coronary heart disease in irregular moderate drinkers was found only in people over 55 years of age, not in the younger group. The reason may be that older people experience lifestyle changes such as retirement, which are often accompanied by increased alcohol consumption, which can lead to differences in risk between ages.
To study the relationship between coronary heart disease and long-term drinking behavior, the researchers analyzed forward-looking longitudinal data on self-reported weekly drinking in six studies, five from the UK and one from France, including information about alcohol consumption and coronary heart disease over a decade.
Long-term drinking behaviors assess intake by self-reported type of alcohol; half pints (about 240ml) of beer or cider, a small glass of red wine and a glass of spirits were reduced to 8g of alcohol in the UK study and 10g in the French study. The standard for moderate drinking is no more than 168 grams of alcohol per week for men and 112 grams per week for women.
authors caution that non-drinkers in the study may also include people who have been drinking but have given up alcohol because of a lack of information on alcohol intake prior to the 10-year study. Severe drinkers with the disease may not be included in the study sample because they are likely to quit the program early in the study. In addition, the six studies included in this study are observational studies, so it is not possible to draw causal conclusions.
summary:
Background
Studies have shown that alcohol intake trajectories differ in their associations with biomarkers of cardiovascular functioning, but it remains unclear if they also differ in their relationship to actual coronary heart disease (CHD) incidence. Using multiple longitudinal cohort studies, we evaluated the association between long-term alcohol consumption trajectories and CHD.
Methods
。 Data were drawn from six cohorts (five British and one French). The combined analytic sample comprised 35,132 individuals (62.1% male; individual cohorts ranging from 869 to 14,247 participants) of whom 4.9% experienced an incident (fatal or non-fatal) CHD event. Alcohol intake across three assessment periods of each cohort was used to determine participants' intake trajectories over approximately 10 years. Time to onset for (i) incident CHD and (ii) fatal CHD was established using surveys and linked medical record data. A meta-analysis of individual participant data was employed to estimate the intake trajectories association with CHD onset, adjusting for demographic and clinical characteristics.
Results
。 Compared to consistently moderate drinkers (males: 1–168 g ethanol/week; females: 1–112 g ethanol/week), inconsistently moderate drinkers had a significantly greater risk of incident CHD [hazard ratio (HR) = 1.18, 95% confidence interval (CI) = 1.02–1.37]. An elevated risk of incident CHD was also found for former drinkers (HR = 1.31, 95% CI = 1.13–1.52) and consistent non-drinkers (HR = 1.47, 95% CI = 1.21–1.78), although, after sex stratification, the latter effect was only evident for females. When examining fatal CHD outcomes alone, only former drinkers had a significantly elevated risk, though hazard ratios for consistent non-drinkers were near identical. No evidence of elevated CHD risk was found for consistently heavy drinkers, and a weak association with fatal CHD for inconsistently heavy drinkers was attenuated following adjustment for confounding factors.
Conclusions
。 Using prospectively recorded alcohol data, this study has shown how instability in drinking behaviours over time is associated with risk of CHD. As well as individuals who abstain from drinking (long term or more recently), those who are inconsistently moderate in their alcohol intake have a higher risk of experiencing CHD. This finding suggests that policies and interventions specifically encouraging consistency in adherence to lower-risk drinking guidelines could have public health benefits in reducing the population burden of CHD. The absence of an effect amongst heavy drinkers should be interpreted with caution given the known wider health risks associated with such intake.(Source: Science.com)