Alcohol and nonfatal myocardial infarction or incidence of CHD

Data on the incidence of myocardial infarction or CHD were available for about 40% of the cited cohorts. It is no longer disputed that drinkers as a group have a lower incidence of

Table 1.1 Large population studies examining alcohol intake and cardiovascular disease

[Reference] Cohort

Baseline Year

Sampling Method

Sample Categories of CHD Size Alcohol Intake

Incidence (N)

[6] Framingham Heart Study

1950

[8] Honolulu Heart 1965-68 Program

1971-74

  • 10] Puerto Rico Heart Health Program
  • 11] Yugoslavia Cardiovascular Disease Study

1965-68

1964-65

[12] Nurses' Health Study

1980

[14] Physicians Health Study

1981-84

Residents aged 29-62 years in Framingham, MA at exam 2

At exam 2 or exam 7 Japanese ancestry (men) aged 45 and older residing on the Hawaiian island of Oahu

Men who survived to exam 3

Male residents aged 35-79 years from three urban and four rural areas of Puerto Rico Male residents aged 35-62 years living in Bosnia and Croatia

Female registered nurses aged 34-59 living inll large states

Male physicians aged 40-84 years in an aspirin/ B-carotene randomized trial

4,7450, 1,2-3,47, 8-19, and 20+oz/ week (men); 0,1,23, 4-9, and 10 +oz/week (women) 4,625oz per month

7,878None, light (1-14 ozJ month), moderate (1539 oz/month), and heavy (>40 ozJ month) 6,069Abstamer, light (1-14 ml/day), moderate (1539 ml/day), and heavy drinker (>40 ml/day) 9,1500, 1-14, 1539, 40-79, and >80 g/day ll,121<monthly, monthly to<weekly, weekly to <daily, daily but not drunk last week, and daily and drunk last week 87,5260, <1.5, 1.54.9, 5.0-14.9, 15.0-24.9, and >25 g/day

85,7090, 0.1-1.4, 1.5-4.9, 5.014.9, 15.029.9, and >30.0 g/day 21,530<1, 1,2-4, 56 drinks/ week,l drink/ day, and >2 drinks/day

21,876<1, 1,2-4, 56, 7-13, and >14 drinks/ week 21,537<1, 1,2-4, 56 drinks/wk, 1 drink/day, and >2 drinks/ day

24 1,490

-400

132 70 (death)

12 1,383

164 (nonfatal MI)

12 2,658

11 1,206

141 (Sudden cardiac)

198283

1986

  • 18] Physicians Health Study enrollment cohort
  • 19] Health Professionals Follow-up Study
  • 201 American Cancer 1959 Society Prospective Study
  • 21] Cancer 1982

Prevention Study II

[22] Kaiser 1978-

Permanente Study 85

  • 23] NHANES I 1971-Epidemiologic Follow-75 up Study
  • 24] Lipid Research Clinics Follow-up Study

197276

  • 25] Post trial follow- 1982 up of the Multiple Risk Factor Intervention Trial
  • 26] British Regional 1978-Health Study 80

Male physicians aged 40-84 years who responded to the initial enrollment questionnaire

Male health professionals aged 4075 years

White men volunteers aged40-59 years

Men and women volunteers aged 30 years or older

Men and women who underwent health examinations in a prepaid health plan

Representative sample of the US resident population aged 40-75 years

Men and women aged 30 years or older who were screened in the Lipid Research Clinics Prevalence Study Men at high risk for developing CHD and survived to the end of the Multiple Risk Factor Intervention Trial

Men aged40-59 years drawn at random from one general practice in each of 24 British towns

21,870<1, 1, 2-4, 5-6 12 drinks/week, and >1 drink/day 89,299rarely/never,l-3 5 3,216 drinks/month, 1, 2-4, 5-6 drinks/ week, 1 drink/ day, and >2 drinks/day 44,0590,0.1-2.0,2.1- 2 5.0, 5.110.0,10.1-15.0, 15.1-30.0, 30.150.0, and >50.0 g/day

276,802None, 12 42,756

occasional, 1, 2, 3, 4, 5,6+ drinks/ day, and irregular drinkers

489,626None, less than 9 46,325 daily, 1 drink/ day, 2-3 drinks/ day, >4 drinks/ day

128,934Lifelong 8 4,503

abstainer, ex-drinker, <1/ month, >1/ month to <l/day, 1-2/day, 3-5/ day, and >6 drinks/day 6,788Lifetime 15

abstainers, current abstainers, <2, 27, 8-14, 15-28, 29-42, and >42 drinks/week 7,4610,1-9, 10-19, 9 20-29, and 30 +ml/day

150 (death)

18,771

10,252

1,560

7,272None, occasional (<1 unit/week), light (1-15 units/ week), moderate (16-42 units/ week), and heavy (>6 units/ day)

17 1,308 901

[Reference] Cohort

Baseline Year

Sampling Method

Sample Categories of Size Alcohol Intake

CHD Yrs*

Death Incidence (N) (N)

Death (N) ,

Stroke+ (N)

[27]

7,273None,

14

216

occasional,

weekend

drinker:l-2, 3-

6, or >6 drinks/

day, and

dailydrinker: 1-

2, 3-6, or >6

drinks/day

[28]

1983-

-85

Survivors at 5 yrs

6,439Lifelong

10

929 490

472

after the initial

teetotaller, ex-

(CVD)

exam

drinker,

occasional (<1/

week), light (1-

15/week),

moderate (16-

42/week), and

heavy (>42

units/week)

[29] British

1978

Male British

12,321None, 1-7, 8-

13

3,328

1,061

380

male

doctors who

14, 15-21, 22-

(death)

physicians

replied to the 1978

28, 29-42, and

alcohol

>43 units/week

questionnaire

[30] Social

1973-

-76

Men aged 40-64

4,5320, <200 g/

5

314

140 89

Insurance

years inl2 cohorts

month, and

(Sudden)

Institution's

drawn from 4

>200 g/month

Mobile Clinic

geographical

health Survey

regions of Finland

(Finland)

[31] Finnish

1985-

-88

Male cigarette

26,556nondrinkers,

6

960

Cancer

smokers aged 50-

light (<24.0 g/

Prevention

69 years in a

day), moderate

Study

primary cancer

(24.l-60.0g/

prevention trial

day), and heavy

(>60.0 g/day)

[32]

1976-

-78

Random, age

13,285Never,

11

2,229

1,119

Copenhagen

stratified samples

monthly,

(CVD)

City Heart

aged 30-79 years

weekly, 1-2

Study

drinks/day, and

3-5 drinks/day

[33] Swedish

1969-

-70

Military conscripts

49,6180, 0.1-14.9, 15-

25

1,473 279 (MI)

233

Conscripts

aged 17-21 years

30, and >30g/

Study

day

[34] Eastern

1978-

-83

Consecutive men

34,0140-occasion,l-

13

2,642

284 427

France study

aged 40-60 years

21, 22-32, 33-

(CVD)

coming for a

54, 55-76, 77-

comprehensive

128, and >128

health appraisal

g/day

[35]Japanese

1965

Male physicians

5,135Nondrinker,

19

1,283

184 525

230

male

from western

exdrinker,

(CVD)

physicians

Japan

occasional

drinker, <54 ml/

day, and >54

ml/day

  • Length of follow-up (years); +Number of incidence cases unless otherwise indicated; CHD=coronary heart disease; CVD=cardiovascular disease; NHANES I=the First National Health and Nutrition Examination Survey.
  • Length of follow-up (years); +Number of incidence cases unless otherwise indicated; CHD=coronary heart disease; CVD=cardiovascular disease; NHANES I=the First National Health and Nutrition Examination Survey.

acute myocardial infarction or CHD than do non-drinkers. However, it is unresolved as to whether there is a dose-response relation between increasing alcohol intake and decreasing incidence and whether there is an increase in risk at the high end of alcohol intake. An inverse relationship between alcohol intake and incidence of CHD was found in the Framingham Heart Study [7], the Yugoslavia Cardiovascular Disease Study [H], the Physicians' Health Study [14], the Health Professional's Follow-up Study [19], and in the middle-aged group (51-64 years) of the Honolulu Heart Program [9], A clear dose-response relationship among drinkers was not found in the British Regional Health Study [26,28], the Nurses' Health Study [12], and the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study [23], The Kaiser Permanente Study of alcohol intake and subsequent hospitalization for acute myocardial infarction showed that compared with lifelong abstainers, a lower risk of hospitalization for CHD was present among those who took alcohol more than monthly to >6 drinks per day [36], There was no apparent difference in the hospitalization rate among the wide ranges of alcohol intake. The majority of studies did not find an increase in the incidence of CHD at the high end of the drinking distribution [9,12,14,26,28,33], However, among females in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study [23], an increased risk was found above 28 drinks per week relative to abstainers. Among males in this study, no upturn in risk was revealed at higher intake. The Honolulu Heart Study reported a higher risk of incident CHD in heavy compared to light male drinkers aged 65 to 75 years [9],

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Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.

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