Roles of Drinking Pattern and Type of Alcohol Consumed in Coronary Heart Disease in Men
Kenneth J. Mukamal, M.D., M.P.H., Katherine M. Conigrave, M.B., B.S., Ph.D., Murray A. Mittleman, M.D., Dr.P.H., Carlos A. Camargo, Jr., M.D., Dr.P.H., Meir J. Stampfer, M.D., Dr.P.H., Walter C. Willett, M.D., Dr.P.H., and Eric B. Rimm, Sc.D.
Background Although moderate drinking confers a decreased riskof myocardial infarction, the roles of the drinking patternand type of beverage remain unclear.
Methods We studied the association of alcohol consumption withthe risk of myocardial infarction among 38,077 male health professionalswho were free of cardiovascular disease and cancer at base line.We assessed the consumption of beer, red wine, white wine, andliquor individually every four years using validated food-frequencyquestionnaires. We documented cases of nonfatal myocardial infarctionand fatal coronary heart disease from 1986 to 1998.
Results During 12 years of follow-up, there were 1418 casesof myocardial infarction. As compared with men who consumedalcohol less than once per week, men who consumed alcohol threeto four or five to seven days per week had decreased risks ofmyocardial infarction (multivariate relative risk, 0.68 [95percent confidence interval, 0.55 to 0.84] and 0.63 [95 percentconfidence interval, 0.54 to 0.74], respectively). The riskwas similar among men who consumed less than 10 g of alcoholper drinking day and those who consumed 30 g or more. No singletype of beverage conferred additional benefit, nor did consumptionwith meals. A 12.5-g increase in daily alcohol consumption overa four-year follow-up period was associated with a relativerisk of myocardial infarction of 0.78 (95 percent confidenceinterval, 0.62 to 0.99).
Conclusions Among men, consumption of alcohol at least threeto four days per week was inversely associated with the riskof myocardial infarction. Neither the type of beverage nor theproportion consumed with meals substantially altered this association.Men who increased their alcohol consumption by a moderate amountduring follow-up had a decreased risk of myocardial infarction.
Source Information
From the Divisions of General Medicine and Primary Care (K.J.M.) and Cardiology (M.A.M.), Beth Israel Deaconess Medical Center, Boston; the Department of Public Health and Community Medicine and the Department of Medicine, University of Sydney, Sydney, New South Wales, Australia (K.M.C.); the Departments of Epidemiology (M.A.M., C.A.C., M.J.S., W.C.W., E.B.R.) and Nutrition (M.J.S., W.C.W., E.B.R.), Harvard School of Public Health, Boston; the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston (C.A.C., M.J.S., W.C.W., E.B.R.); and the Department of Emergency Medicine, Massachusetts General Hospital, Boston (C.A.C.).
Address reprint requests to Dr. Mukamal at the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave., LY-303, Boston, MA 02215, or at kmukamal{at}caregroup.harvard.edu.
Alcohol and Coronary Heart Disease
Duggirala M. K., Bridges C. M., McLeod T. G., Lieber C. S., Lowenfels A. B., Di Castelnuovo A., Iacoviello L., de Gaetano G., Mukamal K. J., Rimm E. B., Goldberg I. J.
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N Engl J Med 2003;
348:1719-1722, Apr 24, 2003.
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