Summary: The authors state that endothelial dysfunction contributes to atherosclerosis and the pathogenesis of cardiovascular disease. Effects of alcohol consumption on endothelial function may be relevant to these cardiovascular outcomes, but very few human studies have examined the effect of alcohol consumption on endothelial function assessed by flow-mediated dilation (FMD) of the brachial artery. In the population-based Northern Manhattan Study (NOMAS), the authors performed a cross-sectional analysis of lifetime alcohol intake and brachial artery FMD during reactive hyperemia using high-resolution B-mode ultrasound images among 883 stroke-free participants (mean age 66.7 years, women 56.6%, Hispanic 67.5%, black 17.5%, and white 14.9%).
Results showed that the mean brachial FMD was 5.68% and the median was 5.52%. Reported lifetime alcohol consumption was as follows: 147 (16.7%) non-drinkers (<1drink/month), 616 (69.8%) >1drink/mo to 2 drinks/day, 59 (6.7%) >2 to 5drinks/day, 60 (6.8%) >5drinks/day. Compared to non-drinkers, those who drank >1 drink/mo to 2 drinks/day were more likely to have FMD above the median (5.5%) of FMD (unadjusted OR 1.7, 95% CI 1.2-2.5, p=0.004). In multivariate analysis, the relationship between moderate alcohol consumption and FMD remained significant after adjusting for multiple traditional cardiovascular risk factors, including age, body mass index, hypertension, diabetes and smoking (adjusted OR 1.5, 95%CI 1.1-2.2, p=0.02). No beneficial effect on FMD was seen for those who drank more than 2 drinks/day. The authors conclude that consumption of up to 2 alcoholic beverages per day independently was associated with improved FMD compared to nondrinkers in this multiethnic population. The effect on FMD may represent an important mechanism in explaining the protective effect of alcohol intake on cardiovascular disease.
Comments: Function of the endothelium, the lining of arteries, is a critical factor associated with the development of atherosclerosis and myocardial infarction. This was a cross-sectional study, so the effects of improved endothelial function on subsequent disease can not be ascertained. The study, however, supports other research findings showing that moderate drinking is associated with better endothelial function.
Moderate alcohol consumption is associated with improved endothelial function. Suzuki K, Elkind MS, Boden-Albala B, Zhezhen J . . . Homma S. Abstracts related to alcohol consumption from the scientific sessions of the American Heart Association, October 4-7, 2007 reviewed by R Curtis Ellison Abst 3644