Page last updated: December 31, 2018

 Association of longitudinal alcohol consumption trajectories with coronary heart disease

A group of researchers evaluated the association between long-term alcohol consumption trajectories and coronary heart disease in a study reported in the journal, BMC Medicine. The investigation found that moderate drinking may be linked to a lower risk of heart disease, and this reduced risk was most pronounced among people who drank moderately in a consistent way. Those who had unstable drinking patterns had a higher risk of coronary heart disease (CHD).

The research used data drawn from six cohorts. The combined analytic sample comprised 35,132 individuals of whom 4.9% experienced an incident (fatal or non-fatal) CHD event. Alcohol intake across three assessment periods was used to determine participants’ intake trajectories over approximately 10 years. A meta-analysis of individual participant data was used to estimate the intake trajectories’ association with CHD onset, adjusting for demographic and clinical characteristics.

Compared to consistently moderate drinkers (males: 1–168 g ethanol/week; females: 1–112 g ethanol/week), inconsistently moderate drinkers had a significantly greater risk of incident CHD [hazard ratio (HR) = 1.18, 95% confidence interval (CI) = 1.02–1.37]. An elevated risk of incident CHD was also found for former drinkers (HR = 1.31, 95% CI = 1.13–1.52) and consistent non-drinkers (HR = 1.47, 95% CI = 1.21–1.78), although, after sex stratification, the latter effect was only evident for females. When examining fatal CHD outcomes alone, only former drinkers had a significantly elevated risk, though hazard ratios for consistent non-drinkers were near identical. No evidence of elevated CHD risk was found for consistently heavy drinkers, and a weak association with fatal CHD for inconsistently heavy drinkers was attenuated following adjustment for confounding factors.

Using prospectively recorded alcohol data, this study has shown how instability in drinking behaviours over time is associated with risk of CHD. As well as individuals who abstain from drinking (long term or more recently), those who are inconsistently moderate in their alcohol intake have a higher risk of experiencing CHD. This finding suggests that policies and interventions specifically encouraging consistency in adherence to lowerrisk drinking guidelines could have public health benefits in reducing the population burden of CHD. The authors state that the absence of an effect amongst heavy drinkers should be interpreted with caution given the known wider health risks associated with such intake.

Source: Association of longitudinal alcohol consumption trajectories with coronary heart disease: a meta-analysis of six cohort studies using individual participant data. D O’Neill, A Britton, MK Hannah, M Goldberg, D Kuh, K Tee Khaw and S Bell. BMC Medicine 201816:124 doi. org/10.1186/s12916-018-1123-6.
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