Does Recent Alcohol Consumption Reduce the Risk of Acute Myocardial Infarction and Coronary Death in Regular Drinkers?

Abstract

This study, conducted in Auckland, New Zealand, over 2 years from March 1986, used a case-control design to investigate the hypothesis that alcohol acutely increases the risk of both nonfatal myocardial infarction and coronary death in the 24 hours after drinking, among regular drinkers. The nonfatal myocardial infarction analyses included 278 male and 60 female cases identified from a population-based coronary heart disease surveillance program and 458 male and 266 female controls randomly selected from the same population matched by age and sex. In the coronary death analyses, 172 male and 16 female coronary death cases from the same surveillance program and a population-based sample of 294 males and 165 females who were age and sex matched were examined. Information on alcohol consumption in the 24 hours before the coronary event in cases and a comparable 24-hour period in controls was collected. Study subjects all drank alcohol regularly at least once per month and were aged 25-64 years. Controls were more likely than cases to report a drinking episode in the 24-hour period examined in both sexes and for fatal and nonfatal disease. After controlling for possible confounding, the authors found that drinkers had a consistently lower estimated risk of both fatal and nonfatal coronary heart disease than participants reporting no alcohol in the previous 24 hours. The odds ratios ranged from 0.75 (95% confidence interval 0.62-0.90) for nonfatal myocardial infarction in men to 0.46 (95% confidence interval 0.19-1.10) for coronary death in women. There were no clear differences in estimated acute risk among those who drank one or two drinks, three or four drinks, or more than four drinks in the 24-hour period. These findings suggest that, contrary to previous speculation, alcohol consumption may acutely reduce coronary heart disease risk.

Should We Use a Case-Crossover Design?

“…Using cases as their own matching controls equalizes past alcohol intake. For example, the traditional case-control study by Jackson et al (15) yielded an odds ratio among men of 0.75 (0.62 to 0.90) for alcohol intake during the 24 h before onset of nonfatal MI, compared with a comparable 24-h period in matched controls. This is consistent with the well-established inverse association between alcohol intake and MI, which could be caused by a combination of ethanol effects-a chronic cumulative protective effect plus a repeated transient protective effect.…”

Medical risks for women who drink alcohol

“…59,73 The cardiovascular benefits of alcohol consumption for women appear to be associated with both habitual and recent alcohol consumption. 74 Mechanisms by which low-level alcohol consumption decreases the risk of cardiovascular disease most likely include chronic alterations in lipids and lipoproteins, as well as more acute antithrombotic effects. 67,[75][76][77] Studies have consistently demonstrated a positive association between alcohol intake and levels of the cardioprotective high-density lipoproteins (HDLs) in women.…”

Is there a role for wine in cancer and the degenerative diseases of aging?

“…Forty grams and 20 g alcohol/day for men and women, respectively, are at the upper end of the moderation range. [21][22][23][24] Subsequent studies have also independently assessed the association between alcohol consumption and cognitive function and have affirmed the observations of Zuccala and colleagues 26 but have also provided more detailed data. [158][159][160][161][162] For example, Reid and colleagues 161 in a study of 760 US men aged 65 years or older showed that current light to moderate alcohol consumption which was considered as up to approximately 70 g/week, compared to abstinence, had better cognitive function.…”

“…Latruffe and colleagues 85 examined the effect of resveratrol on two different human tumor cell lines, and has shown that resveratrol is actually taken up by the cells, whereupon it is conjugated and released into the cell medium by the hepatic HepG2 cells and to a lesser extent by colorectal tumor SW480 cells. 21 Phenolic compounds may not be antiproliferative or active against all tumor cell lines, however, as no uptake and conjugation was observed with cells from the intestine. Elattar and Virji 78 examined the effect of quercetin alone and in combination with resveratrol on human oral squamous carcinoma cells (SCC-25), and showed that quercetin is an equipotent inhibitor of SCC-25 cell growth and DNA synthesis, but the combination of quercetin and resveratrol was most potent.…”

“…[6][7][8] Data is now accumulating which suggests that the regular and moderate consumption of alcohol may reduce the risk of Alzheimer's disease, bone mineral density, chronic obstructive airways disease, diabetes, disorders of the immune system, gallstones, gastrointestinal diseases, kidney stones, osteoporosis, rheumatoid arthritis, and agerelated visual impairment, or macular degeneration in addition to psychological or social benefits. [9][10][11][12][13][14][15][16][17][18][19][20] While the literature defines consistently light to moderate consumption as 20 to 40 g alcohol/day, [21][22][23][24] several studies have defined moderate consumption as up to 80 g alcohol/day for men, 25,26 which may reflect country and cultural differences in alcohol consumption. 27 Above moderate consumption the risk of alcohol-related diseases increases dose-dependently.…”