Alcohol Consumption and Mortality From Coronary Heart Disease: An Updated Meta-Analysis of Cohort Studies

Abstract

Previous meta-analyses estimate that lowvolume alcohol consumption protects against coronary heart disease (CHD). Potential errors in studies include systematic misclassification of drinkers as abstainers, inadequate measurement, and selection bias across the life course. Method: Prospective studies of alcohol consumption and CHD mortality were identified in scholarly databases and reference lists. Studies were coded for potential abstainer biases and other study characteristics. The alcohol-CHD risk relationship was estimated in mixed models with controls for potential biases. Stratified analyses were performed based on variables identified as potential effect modifiers. Results: Fully adjusted meta-analysis of all 45 studies found significantly reduced CHD mortality for current low-volume drinkers (relative risk [RR] = 0.80, 95% CI [0.69, 0.93]) and all current drinkers (RR = 0.88, 95% CI [0.78, 0.99]). There was evidence of effect modification by cohort age, gender, ethnicity, and heart health at baseline. In stratified analyses, low-volume consumption was not significantly protective for cohorts ages 55 years or younger at baseline (RR = 0.95, 95% CI [0.75, 1.21]), for studies controlling for heart health (RR = 0.87, 95% CI [0.71, 1.06]), or for higher quality studies (RR = 0.86, 95% CI [0.68, 1.09]). In studies in which the mean age was 55 years or younger at baseline, there were significantly increased RRs for both former (RR = 1.45, 95% CI [1.08, 1.95]) and occasional drinkers (RR = 1.44, 95% CI [1.09, 1.89]) compared with abstainers. Conclusions: Pooled analysis of all identified studies suggested an association between alcohol use and reduced CHD risk. However, this association was not observed in studies of those age 55 years or younger at baseline, in higher quality studies, or in studies that controlled for heart health. The appearance of cardio-protection among older people may reflect systematic selection biases that accumulate over the life course.

Risky Alcohol Use: The Impact on Health Service Use

“…The literature supports the fact that alcohol consumption, for the vast majority of conditions has a linear relationship between the volume of alcohol consumed and the risk of morbidity and mortality [15][16][17]. Alcohol abuse and dependence are clearly associated with an increased health service use and it has been shown that alcohol reduction and abstention in this specific population reduce health service use [8,18].…”

ALDH2 gene G487A polymorphism and coronary artery disease: a meta‐analysis including 5644 participants

“…However, our current meta‐analysis still lacks large‐scale or prospective studies on the relationship of ALDH2 gene G487A polymorphism and CAD. It is well known that the individuals without alcohol consumption have the higher CAD risk than the moderate drinkers . In the abstainers, the ALDH2 gene G487A polymorphism might not have the same role as that in the alcohol users.…”

“…Additionally, in 2017, Zhao et al . also performed an updated meta‐analysis on the association of alcohol consumption and CAD mortality, they found that moderate alcohol use was associated with reduced CAD risk .…”

When an enemy becomes a friend. On the benefits of alcohol consumption

“…Вместе с тем употребление алкоголя, напротив, ассоциировалось с повышением летальности у лиц 55 лет и младше к моменту начала наблюдения. Для употреблявших спиртные напитки в прошлом ОР соста-вил 1,45, для эпизодически пьющих -1,44 [19].…”