Light, moderate alcohol consumption linked with reduced CVD mortality

Light and moderate alcohol consumption were both associated with a decrease in CVD mortality, but heavier consumption was not, according to results from an analysis.

U.S. researchers analyzed alcohol data from nine National Health Interview Survey samples (1987 to 1988, 1990 to 1992 and 1997 to 2000). After dividing the sample of 245,207 participants into either abstainers or current drinkers, they then devised six categories of alcohol consumption. These included never drinkers (<12 drinks in one’s lifetime); lifetime infrequent drinkers (>12 drinks in one’s lifetime, <12 drinks in previous years); former drinkers (>12 drinks in one’s lifetime, >12 drinks in a previous year); light current drinkers (current use of <3 drinks per week); moderate drinkers (current use of >3 to 7 drinks per week for women and >3 to 14 drinks per week for men); and heavy drinkers (current use of >7 drinks per week for women and >14 drinks per week for men). Mortality data were obtained via linkage to the National Death Index through 2002.

There were 10,670 CVD deaths reported during the 1,987,439 person-years of follow-up. The researchers reported an inverse association with CV mortality in participants consuming light and moderate quantities of alcohol.

“In general, the association of light and especially moderate drinking with low risk was observed to similar degrees across all subgroups, although estimates tended to be further below 1 for coronary than stroke mortality, particularly for heavy drinking,” the researchers wrote.

Light drinkers (HR=0.73; 95% CI, 0.64-0.83) and moderate drinkers (HR=0.71; 95% CI, 0.59-0.85) demonstrated an inverse association with CV deaths that were not coded as ischemic or cerebrovascular. When compared with lifetime abstainers, the reported summary RRs were 0.95 (95% CI, 0.88-1.02) for lifetime infrequent drinkers, 1.02 (95% CI, 0.94-1.11) for former drinkers, 0.69 (95% CI, 0.59-0.82) for light drinkers, 0.62 (95% CI, 0.50-0.77) for moderate drinkers and 0.95 (95% CI, 0.82-1.10) for heavy drinkers. Risks were higher among participants who consumed at least three drinks daily vs. those consuming two drinks per day, although no simple relationship between the frequency and quantity of alcohol consumption and risk was reported.

“The magnitude of lower risk was generally strongest for CHD mortality and among non-Hispanic whites,” the researchers wrote. “These data bolster previous epidemiological studies that have found lower rates of incident CVD among moderate drinkers but also provide cautionary evidence that drinking above recommended limits eliminates this risk reduction.”

In an accompanying editorial, Arthur L. Klatsky, MD, of the Oakland Medical Center in Oakland, Calif., said that the data comport with previous data indicating the relationship between alcohol consumption and CV mortality risk.

“This characteristically elegant presentation from a leading group in the alcohol epidemiology field confirms a U–shaped relationship between alcohol intake and CV mortality in a large, nationwide study population,” Klatsky wrote. “As expected, most of the apparent benefit in light–moderate drinkers is due to lower risk for CAD death.”

Klatsky also cautioned that the data should not be taken as the final verdict on the subject. “Absolute proof that [people] at CAD risk obtain benefit from light–moderate drinking will not appear soon,” he concluded.

Mukamal KJ. J Am Coll Cardiol. 2010;55:1328-1335.

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