The impact of long-term moderate and heavy alcohol consumption on incident atherosclerosis among persons living with HIV

Abstract

Background Level of alcohol consumption is associated with differential risk of atherosclerosis, but little research has investigated this association among HIV+ persons. We evaluated the association between long-term alcohol use and incident atherosclerosis among HIV+ persons. Methods We utilized data from HIV+ participants of the Women’s Interagency HIV Study (n = 483) and the Multicenter AIDS Cohort Study (n = 305) without history of cardiovascular disease. Atherosclerosis was assessed two times by B-mode carotid artery ultrasound imaging from 2004 to 2013. Presence of plaque was defined as focal carotid intima-media thickness over 1.5 mm. Those with no plaque at baseline and plaque at follow-up were considered incident cases of atherosclerosis. Group-based trajectory models were used to categorize participants into 10-year drinking patterns representing heavy, moderate, or abstinent-low. Multivariable logistic regressions were conducted to assess the association of long-term moderate and heavy use on atherosclerosis, compared to abstinent-low. Results Heavy alcohol consumption was not statistically significantly associated with risk for incident atherosclerosis in women (AOR 1.10, CI 0.40–3.02) or men (AOR 1.31, CI 0.43–4.00), compared to abstinence-low. Moderate consumption was associated with 54% lower odds for incident disease in men (AOR 0.46, CI 0.21–1.00), but not in women (AOR 1.08, CI 0.58–2.00). In cohort-combined analyses, alcohol consumption was not statistically significantly association with incident atherosclerosis (moderate AOR 0.78, CI 0.48–1.27; heavy AOR 1.33, CI 0.66–2.69). Conclusion Moderate alcohol consumption was associated with a significant protective effect on incident atherosclerosis in men only. No other levels of alcohol consumption significantly predicted atherosclerosis in men and women compared to abstinent-low.

Alcohol consumption in relation to carotid subclinical atherosclerosis and its progression: results from a European longitudinal multicentre study

“…Our findings of moderate alcohol consumption in relation to decreased C-IMT measured at baseline confirm the results of some earlier studies [ 9 , 10 , 13 – 17 , 19 , 21 , 36 ] but not all [ 11 , 25 , 30 , 32 – 34 ]. Among the few studies [ 12 , 36 ] that have investigated the association between alcohol consumption and progression of atherosclerosis including both men and women, our study is one of the largest. Our findings of lower C-IMT progression in relation to moderate and high alcohol consumption, as compared to very low consumption, agree to some extent with those reported from an Italian study ( n = 780) [ 12 ] but disagree with those of an American study ( n = 788) [ 36 ].…”

“…Some of the studies have described the relationship between alcohol consumption and atherosclerosis as linear, with either increased [ 22 , 25 ] or decreased C-IMT [ 13 , 16 ] associated with a rise in alcohol consumption, whereas others report a J-shaped association, with a decrease of C-IMT with moderate alcohol consumption and an increase of C-IMT with high alcohol consumption [ 9 , 14 , 15 , 17 ]. Few studies, mainly performed in men [ 23 , 24 , 27 , 28 ], often with heavy or binge drinking habits [ 23 , 24 , 27 ], have investigated the relationship between alcohol consumption and progression of atherosclerosis, and results were discrepant [ 12 , 23 , 24 , 27 , 28 , 36 ].…”

Research Article The <i>eNOS</i> T786C polymorphism is not related to atherosclerosis and cofactors in a Brazilian population

“…Regarding drinking habits, we did not find association between this social habit and the development of atherosclerosis. Recently, this relationship was found to be positive in patients with atherosclerosis and other cardiovascular diseases in other populations studied elsewhere (Kelso-Chichetto et al, 2017).…”

HIV and Cardiovascular Disease: Update on Clinical Events, Special Populations, and Novel Biomarkers

“…A meta-analysis between 1999 and 2014 found only 13 eligible studies and estimated that heavy alcohol use was associated with 37% [95% CI 1.02–1.84] increased risk of cardiovascular disease compared to non-heavy use [98]. Recent longitudinal data from the Women’s Interagency HIV Study (WIHS) and the Multicenter AIDS Cohort Study (MACS) did not find an association of heavy alcohol use and incident atherosclerosis [99]. A prior cross-sectional study from MACS found an association between heavy alcohol use and the presence of coronary artery stenosis with no significant association for low/moderate drinking among PLWHA [96].…”