A recent Danish study sought to determine the association between alcohol drinking patterns and risk of coronary heart disease in women and men.
The authors state that whilst prospective studies have consistently reported a lower risk of coronary heart disease among consumers of moderate alcohol compared with abstainers, few studies have investigated this association by also including various measures of alcohol drinking patterns. From such studies, results consistently imply that the pattern of drinking is important and that steady drinking is more beneficial than drinking in binges. In a recent such study among men, it was suggested that drinking frequency is the primary determinant of the inverse association between alcohol intake and coronary heart disease, and that alcohol intake is less important. Data on the importance of drinking patterns among women are limited and results obtained among men may not apply to women for different reasons. Firstly, sex differences in alcohol pharmacokinetics have been reported, suggesting that men have more efficient first pass metabolisms than women whereas women may eliminate alcohol faster than men. Secondly, oestrogen has beneficial effects on the cardiovascular system, and studies have suggested that alcohol increases oestrogen levels.
Participants for the study included 28,448 women and 25,052 men aged 50-65 who were free of coronary heart disease at entry to the study. Information was gathered from a food frequency questionnaire that established total alcohol consumption and drinking frequency for each participant. Participants were categorised by drinking frequency. During follow-up after 5 years, 749 women and 1283 men developed coronary heart disease.
For men an inverse association was found between drinking frequency and risk of coronary heart disease across the entire range of drinking frequencies. Hazard ratios were 0.93 (0.75 to 1.16) for drinking on one day a week, 0.78 (0.66 to 0.94) for 2-4 days a week, 0.71 (0.57 to 0.87) for five or six days a week, and 0.59 (0.48 to 0.71) for seven days a week.
The study found that women who drank alcohol on at least one day a week had a lower risk of coronary heart disease than women who drank alcohol on less than one day a week. However, risks were similar for drinking on one day a week (36% reduced risk), or seven days a week (35% reduced risk). Among women drinking on 2-4 days a week the hazard ratio was 0.78 (0.63 to 0.97) for 1-6 drinks a week, 0.74 (0.57 to 0.96) for 7-13 drinks a week, and 0.27 (0.13 to 0.58) for 14 or more drinks a week.
The researchers conclude that among women alcohol intake may be the primary determinant of the inverse association between drinking alcohol and risk of coronary heart disease whereas among men, drinking frequency, not alcohol intake, seems more important.
Source:Prospective study of alcohol drinking patterns and coronary heart disease in women and men BMJ Volume 332, pp 1244-7