Moderate alcohol consumption associated with reduced CV mortality, events
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Moderate alcohol consumption was associated with reduced risk for both CV mortality and events among patients with CVD, according to a study published in BMC Medicine.
“While light to moderate alcohol consumption is associated with lower risk of developing multiple cardiovascular outcomes in general population cohorts, it is difficult to extend the posited cardioprotective effects to CVD patients because of their typically older age and compromised vasculature as well as the medications they take to prevent secondary events,” Chengyi Ding, PhD student from the department of epidemiology and public health at the University College London, and colleagues wrote. “In addition, for CVD patients, there are concerns about the potential detrimental effects of alcohol on the circulatory system, such as hypertension, arrhythmias and hemorrhagic stroke, which may exacerbate their existing pathological conditions.”
Researchers evaluated alcohol consumption related to all-cause mortality, CV mortality and CV events through analyzing 14,386 patients with a history of MI (n = 5,333), angina (n = 9,589) or stroke (n = 2,064) from the UK Biobank study and 2,802 patients from 15 waves of the Health Survey for England 1994-2008 and three waves of the Scottish Health Survey 1995, 1998 and 2003 with a history of MI/angina (n = 2,341) or stroke (n = 535). This data was combined with findings from 12 published studies that provided data on 31,235 patients with 5,095 deaths and 1,414 CV events.
There were 1,640 deaths during a median follow-up period of 8.7 years for the UK Biobank study and 1,257 deaths during 9.5 years for the two health surveys. Of these deaths, 39.1% from the U.K. Biobank and 38.5% from the health surveys were due to CV causes.
Moderate consumption and reduced risk
Moderate alcohol consumption was associated with reduced risk for all-cause mortality peaking at 7 g per day (RR = 0.79; 95% CI, 0.73-0.85), CV mortality peaking at 8 g per day (RR = 0.73; 95% CI, 0.64-0.83) and CV events peaking at 6 g per day (RR = 0.5; 95% CI, 0.26-0.96) relative to current nondrinkers. These results remained significant when increased to consumption as much as 62 g per day, 50 g per day and 15 g per day, respectively.
Among studies excluding former drinkers from the nondrinking reference group, there was a reduced risk for all-cause mortality, CV mortality and CV events among those who were light to moderate drinkers. There was a 50% lower risk for recurrent MI, angina or stroke among those who drank 6 g per day, 27% lower risk for death due to MI, stroke or angina among those who drank 8 g per day and 21% lower risk for all-cause death among those who drank 7 g per day compared with nondrinkers.
Researchers observed no statistically significant increased risks with higher levels of alcohol consumption.
Study limitations
According to a press release, these results may have overestimated the reduced risk for recurrent MI, stroke, angina and death for moderate drinkers with CVD possibly due to underrepresenting heavy drinkers and categorization of former drinkers who may have stopped drinking.
“Our findings suggest that people with CVD may not need to stop drinking in order to prevent additional heart attacks, strokes or angina, but that they may wish to consider lowering their weekly alcohol intake,” Ding said in the release. “As alcohol consumption is associated with an increased risk of developing other illnesses, those with CVD who do not drink should not be encouraged to take up drinking.”
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