Alcohol Dosing and Total Mortality in Men and Women

Castelnuovo, Augusto Di

doi:10.1001/archinte.166.22.2437

Cited by 775 publications

(249 citation statements)

References 54 publications

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“…Combining data from 34 prospective studies with 1 015 835 individuals, Costanzo and colleagues 30 concluded that light levels of alcohol consumption were inversely associated with all-cause mortality in both men and women. Similarly, a comprehensive review and meta-analysis based on 84 prospective cohort studies 20 reported that the consumption of alcohol in a light to moderate quantity (2.5-14.9 g/d) was inversely associated with cardiovascular events, with relative risks of 0.71 (95% CI, 0.66-0.77) for incident coronary heart disease and 0.75 (95% CI, 0.68-0.81) for coronary heart disease mortality.…”

Section: In the Context Of Published Literaturementioning

confidence: 99%

Light to Moderate Alcohol Consumption Is Associated With Lower Risk of Aortic Valve Sclerosis

Markus

Lieb

Stritzke

et al. 2015

ATVB

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Objective-In developed countries, sclerotic and calcific degeneration of the aortic valve is a common disorder showing pathophysiologic similarities with atherothrombotic coronary disease. Light to moderate alcohol consumption has been associated with a lower risk for atherothrombotic coronary disease and mortality. Whether alcohol consumption affects the development of aortic valve sclerosis (AVS) is not well known. In the present study, we aim to analyze the crosssectional association between average daily alcohol consumption and AVS in the general population. Approach and Results-We analyzed cross-sectional data from 2022 men and women, aged 45 to 81 years, from the population-based Study of Health in Pomerania. We used a computer-assisted interview that included beverage-specific questions about quantity and frequency of alcohol over the last 30 days to calculate the average quantity of alcohol consumption (in grams of ethanol per day). AVS was ascertained by echocardiography. The prevalence of AVS was 32.3%. Average daily alcohol intake displayed a J-type relation with AVS (fully adjusted P value: 0.005). Compared with individuals with an average consumption of 10 g of alcohol per day, multivariable-adjusted odds ratios were 1.60 (95% confidence interval, 1.19-2.14) among current abstainers and 1.56 (95% confidence interval, 1.01-2.41) among individuals with an average consumption of 60 g per day. Conclusions-Our

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Section: In the Context Of Published Literaturementioning

confidence: 99%

Light to Moderate Alcohol Consumption Is Associated With Lower Risk of Aortic Valve Sclerosis

Markus

Lieb

Stritzke

et al. 2015

ATVB

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“…An excellent and very recent updated meta-analysis of 34 prospective studies was published by Di Castelnuovo and associates 6 to show the relationship between alcohol dosing and total mortality. The 34 studies in men and women included information on Ͼ1 million subjects and Ͼ94 500 deaths.…”

Section: Alcohol and Total And Cardiovascular Mortalitymentioning

confidence: 99%

“…Risk of total mortality and 95% CIs for drinks of alcohol per day taken from 56 curves as part of a meta-analysis, using fixed and random-effects models. Reprinted from Di Castelnuovo et al, 6 with permission from the publisher. Copyright © 2006, the American Medical Association.…”

Section: Alcohol and Total And Cardiovascular Mortalitymentioning

confidence: 99%

To Drink or Not to Drink? That Is the Question

2007

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Abstract-Numerous studies have used a J-shaped or U-shaped curve to describe the relationship between alcohol use and total mortality. The nadir of the curves based on recent meta-analysis suggested optimal benefit at approximately half a drink per day. Fewer than 4 drinks per day in men and fewer than 2 per day in women appeared to confer benefit. Reductions in cardiovascular death and nonfatal myocardial infarction were also associated with light to moderate alcohol intake. Although some studies suggested that wine had an advantage over other types of alcoholic beverages, other studies suggested that the type of drink was not important. Heavy drinking was associated with an increase in mortality, hypertension, alcoholic cardiomyopathy, cancer, and cerebrovascular events, including cerebrovascular hemorrhage. Paradoxically, light-to-moderate alcohol use actually reduced the development of heart failure and did not appear to exacerbate it in most patients who had underlying heart failure. Numerous mechanisms have been proposed to explain the benefit that light-to-moderate alcohol intake has on the heart, including an increase of high-density lipoprotein cholesterol, reduction in plasma viscosity and fibrinogen concentration, increase in fibrinolysis, decrease in platelet aggregation, improvement in endothelial function, reduction of inflammation, and promotion of antioxidant effects. Controversy exists on whether alcohol has a direct cardioprotective effect on ischemic myocardium. Studies from our laboratory do not support the concept that alcohol has a direct cardioprotective effect on ischemic/reperfused myocardium. Perhaps the time has come for a prospectively randomized trial to determine whether 1 drink per day (or perhaps 1 drink every other day) reduces mortality and major cardiovascular events. Key Words: alcohol Ⅲ arrhythmia Ⅲ cardiomyopathy Ⅲ heart failure Ⅲ myocardial infarction A lcohol is an old drug that has attracted human interest for thousands of years. Evidence of wine making was depicted on the walls of the temples of the pharaohs in Egypt and the Sumerians of Mesopotamia. Scientific debate about the risks and benefits of alcohol started in Europe several centuries ago and continues today. How much alcohol should people drink, what should they drink, and who should be doing the drinking are important questions that need definitive answers. This article provides an in-depth analysis of the effect of alcohol on the human heart and its clinical relevance to patient care.A recurring theme is that although high doses of alcohol are harmful to the heart (cardiomyopathy, arrhythmias, and hypertension), mild to moderate alcohol consumption has been associated with reductions in coronary artery disease and even total mortality.When we reviewed the literature, it became very evident that definitions describing how much alcohol is in a drink vary remarkably by article and country, and terms such as light, moderate, and heavy drinking are variably defined. Table 1 provides some of the definitions we could...

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“…It is significant to point out that there was a 2-fold increase in MI in subjects who consumed at least five drinks per day compared to non-drinkers [64]. Cardioprotective dosage of alcohol intake is considered to be 1 or two drinks per day for men and one drink per day for women [53,65,66]. A drink is equivalent to approximately 14 g of ethanol, which would be equivalent to 12 oz beer or 5 oz wine or 1.5 oz 80-proof spirits.…”

Section: Frequency Of Ethanol Intake In Cardioprotectionmentioning

confidence: 99%

Is alcohol beneficial or harmful for cardioprotection?

et al. 2009

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While the effects of chronic ethanol consumption on liver have been well studied and documented, its effect on the cardiovascular system is bimodal. Thus, moderate drinking in many population studies is related to lower prevalence of coronary artery disease (CAD). In contrast, heavy drinking correlates with higher prevalence of CAD. In several other studies of cardiovascular mortalities, abstainers and heavy drinkers are at higher risk than light or moderate drinkers. The composite of this disparate relation in several population studies of cardiovascular mortality has been a ''U-'' or ''J-''shaped curve. Apart from its ability to eliminate cholesterol from the intima of the arteries by reverse cholesterol transport, another major mechanism by which HDL may have this cardioprotective property is by virtue of the ability of its component enzyme paraoxonase1 (PON1) to inhibit LDL oxidation and/or inactivate OxLDL. Therefore, PON1 plays a central role in the disposal of OxLDL and thus is antiatherogenic. Furthermore, PON1 is a multifunctional antioxidant enzyme that can also detoxify the homocysteine metabolite, homocysteine thiolactone (HTL), which can pathologically cause protein damage by homocysteinylation of the lysine residues, thereby leading to atherosclerosis. We demonstrated that moderate alcohol up regulates liver PON1 gene expression and serum activity, whereas heavy alcohol consumption had the opposite effects in both animal models and in humans. The increase in PON1 activity in light drinkers was not due to preferential distribution of high PON1 genotype in this group. It is well known that wine consumption in several countries shows a remarkable inverse correlation to local rates of CAD mortality. Significantly, apart from its alcohol content, red wine also has polyphenols such as quercetin and resveratrol that are also known to have cardioprotective effects. We have shown that quercetin also up regulates PON1 gene in rats and in human liver cells. The action of quercetin seems to be mediated via the active form of the nuclear lipogenic transcription factor, sterol-regulatory element-binding protein 2 (SREBP2) that is translocated from endoplasmic reticulum to the nucleus. However, the mechanism of action of ethanol-mediated up-regulation of PON1 gene remains to be elucidated. We conclude that both moderate ethanol and quercetin, the two major components of red wine, exhibit cardioprotective properties via the up-regulation of the antiatherogenic gene PON1.

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Alcohol Dosing and Total Mortality in Men and Women

Cited by 775 publications

References 54 publications

Light to Moderate Alcohol Consumption Is Associated With Lower Risk of Aortic Valve Sclerosis

Light to Moderate Alcohol Consumption Is Associated With Lower Risk of Aortic Valve Sclerosis

To Drink or Not to Drink? That Is the Question

Is alcohol beneficial or harmful for cardioprotection?

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