Low Amounts of Average Alcohol Consumption Associated With Less Heart Disease, More Stroke

Despite myriad known risks, whether or not alcohol has any health benefits continues to be an open question. Investigators analyzed data from a European prospective cohort study of men and women aged 35–70—which included 17,594 incident cases of cardiovascular disease ascertained by questionnaire, medical records, and registries—and 16,244 randomly selected controls. Analyses were adjusted for age, height, body mass index, smoking, hypertension, and physical activity. There were 9307 first non-fatal and 1699 fatal coronary heart disease (CHD) events, and 5855 non-fatal and 733 fatal strokes.

• Average alcohol consumption at study entry was associated with less non-fatal (hazard ratio [HR] 0.94 for every additional 12 grams/day of alcohol) and fatal CHD (e.g. HR 0.83 at 5-15 g/d) but was not associated with stroke (no amount of alcohol was protective for stroke).
• Alcohol consumption averaged over decades was also protective for non-fatal CHD but not for non-fatal stroke.
• Wine and beer were protective for non-fatal CHD, beer was associated with more non-fatal stroke (wine was not), and spirits were associated with neither.

Comments: These are the sorts of results that raise serious questions about the validity and utility of observational studies of alcohol’s purported health benefits. Results are inconsistent by alcohol type and cardiovascular outcome. The more studies that are done and published, the more questions are raised about whether alcohol has any health benefits at all.

Richard Saitz, MD, MPH

Reference: Ricci C, Wood A, Muller D, et al. Alcohol intake in relation to non-fatal and fatal coronary heart disease and stroke: EPIC-CVD case-cohort study. BMJ. 2018;361:k934.