A study by Maryline Foerester and colleagues examined the impact of heavier drinking on 10-year coronary artery disease (CAD) risk in a population with high mean alcohol consumption.
In a population-based study of 5,769 adults (aged 35 to 75 years) without cardiovascular disease in Switzerland, 1-week alcohol consumption was categorised as 0, 1 to 6, 7 to 13, 14 to 20, 21 to 27, 28 to 34, and ≥35 drinks/week or as nondrinkers (0 drinks/week), moderate (1 to 13 drinks/week), high (14 to 34 drinks/week), and very high (≥35 drinks/week). Blood pressure and lipids were measured, and 10-year CAD risk was calculated according to the Framingham risk score. 73% (n = 4,214) of the participants consumed alcohol; 16% (n = 909) were high drinkers and 2% (n = 119) very high drinkers.
In multivariate analysis, increasing alcohol consumption was associated with higher high-density lipoprotein cholesterol; triglycerides, and systolic and diastolic blood pressure. Ten-year CAD risk increased from 4.31 ± 0.10% to 4.90 ± 0.37% (p = 0.03) with alcohol use, with a J-shaped relation. Increasing wine consumption was more related to high-density lipoprotein cholesterol levels, whereas beer and spirits were related to increased triglyceride levels.
As expected, the researchers conclude that, as measured by 10-year CAD risk, the protective effect of alcohol consumption disappears in very high drinkers, because the beneficial increase in high-density lipoprotein cholesterol is offset by the increases in blood pressure levels.
Source: American Journal of Cardiology published online 17 November 2008.