Alcohol and Coronary Heart Disease: Differences Between Whites and Blacks
To evaluate the relationship between alcohol consumption and the incidence of coronary heart disease (CHD) in whites and blacks, researchers examined data from 14,506 men and women (5% of whom experienced a CHD event at some point during an average follow-up of 10 years). Findings from analyses adjusted for age, smoking, body mass index, low-density lipoprotein cholesterol, waist:hip ratio, education, income, and physical activity include the following:
- Among white men, the incidence of CHD decreased significantly with each additional 13 g of alcohol (approximately 1 drink) consumed per day (hazard ratio, HR, 0.9, compared with never drinking). Among black men, the incidence increased (HR 1.1), though increases were not linear across categories of consumption.
- Among white women, risk decreased with consumption of <1 drink on average per week (HR 0.5), 1 g–69 g per week (HR 0.6, borderline significance) and >=70 g of alcohol per week (HR 0.5). The number of black women was too small to determine risk.
- In analyses adjusted for additional potential confounders (high density lipoprotein cholesterol level, systolic blood pressure, and antihypertensive medication use), consumption affected risk significantly only among white women who drank <1 drink per week on average (HR 0.5).
This study found that moderate alcohol consumption lowered risk of CHD in whites, but increased risk in black men. Because of relatively small numbers of black subjects and an inconsistent pattern of increases in risk with increasing alcohol consumption, these results cannot be considered definitive without replication. Further, even if additional studies find differences by race, the reasons for such differences must be determined.R. Curtis Ellison, MD
Fuchs FD, Chambless LE, Folsom AR, et al. Association between alcoholic beverage consumption and incidence of coronary heart disease in whites and blacks: the Atherosclerosis Risk in Communities Study. Am J Epidemiol. 2004;160(5):466–474.