Alcohol and Immediate Risk of Cardiovascular Events

Abstract

Background Although considerable research describes the cardiovascular effects of habitual moderate and heavy alcohol consumption, the immediate risks following alcohol intake have not been well characterized. Based on its physiological effects, alcohol may have markedly different effects on immediate and long-term risk. Methods and Results We searched CINAHL, Embase, and PubMed from inception to March 12 2015, supplemented with manual screening for observational studies assessing the association between alcohol intake and cardiovascular events in the following hours and days. We calculated pooled relative risks (RRs) and 95% confidence intervals (CIs) for the association between alcohol intake and myocardial infarction (MI), ischemic stroke (IS) and hemorrhagic stroke (HS) using DerSimonian and Laird random-effects models to model any alcohol intake or dose-response relationships of alcohol intake and cardiovascular events. Among 1056 citations and 37 full-text articles reviewed, 23 studies (29457 participants) were included. Moderate alcohol consumption was associated with an immediately higher cardiovascular risk that was attenuated after 24 hours, and even protective for MI and HS (≈2–4 drinks: RR=30% lower risk), and protective against IS within one week (≈6 drinks: 19% lower risk). In contrast, heavy alcohol drinking was associated with higher cardiovascular risk in the following day (≈6–9 drinks: RR=1.3–2.3) and week (≈19–30 drinks: RR=2.25–6.2). Conclusions There appears to be a consistent finding of an immediately higher cardiovascular risk following any alcohol consumption but by 24 hours, only heavy alcohol intake conferred continued risk.

Alcohol Abuse and Cardiac Disease

“…Taken along with prior literature on gradations of alcohol consumption and MI risk, these data on alcohol abuse therefore suggest that the impact of alcohol consumption on incident MI may mirror the “U-shaped curve” found with alcohol consumption and overall mortality (36–38) and are consistent with the observation that acute binges of alcohol increase the risk of MI (39). Of interest, a recent analysis suggests that the apparent protective effect of light to moderate drinking on mortality maybe confounded by physical activity and perceived health status (40).…”

The relationship between different dimensions of alcohol use and the burden of disease—an update

“…Clearly, chronic heavy drinking is detrimental (for blood pressure/hypertension 241, 242; ischaemic heart disease 243; cardiomyopathy 244; atrial fibrillation and flutter 245; all types of stroke 246), but there is also evidence for an increased risk associated with irregular heavy drinking, even in people who are on average light to moderate drinkers (ischaemic heart disease 247, 248, 249; ischaemic stroke 250; all types of stroke 251; different cardiovascular outcomes 252). For the effects of irregular heavy drinking occasions on cardiovascular disease, there are potentially four main mechanisms 253.…”

Interactions between genetic polymorphisms of glucose metabolizing genes and smoking and alcohol consumption in the risk of type 2 diabetes mellitus

“…Smoking and drinking (especially heavy alcohol consumption) are known risk factors for diabetes (Cullmann et al 2012;Ko et al 2011;Lajous et al 2013;Pietraszek et al 2010;Willi et al 2007;Zhang et al 2011). Both smoking and alcohol can induce an increased risk of cardiovascular disease, which is an established independent risk for insulin resistance and T2DM (Briasoulis et al 2012;Cosselman et al 2015;Mostofsky et al 2016;Pan et al 2015). Furthermore, it has been reported that cigarette smoking (Briasoulis et al 2012;Cosselman et al 2015;Mostofsky et al 2016;Pan et al 2015) (Akter et al 2015;Mostofsky et al 2016).…”

“…Both smoking and alcohol can induce an increased risk of cardiovascular disease, which is an established independent risk for insulin resistance and T2DM (Briasoulis et al 2012;Cosselman et al 2015;Mostofsky et al 2016;Pan et al 2015). Furthermore, it has been reported that cigarette smoking (Briasoulis et al 2012;Cosselman et al 2015;Mostofsky et al 2016;Pan et al 2015) (Akter et al 2015;Mostofsky et al 2016).…”