Drinking May Increase Coronary Calcification in Blacks and Binge Drinkers
Moderate drinking may improve cardiovascular health, possibly by protecting against atherosclerosis. To examine this further, researchers assessed alcohol consumption, coronary heart disease risk factors, and coronary calcification (a marker for atherosclerosis) in 3037 adults during 15 years of follow-up. Subjects were aged 33-45 years at follow-up; 55% were women and 45% were black.
- As alcohol intake increased (from 0 to >=14 drinks per week), high-density lipoprotein cholesterol and blood pressure levels increased while mean C-reactive protein and fibrinogen levels decreased.
- The prevalence of coronary calcification (calcium scores >0 on computed tomography scanning) also increased as drinking increased (8% of those who abstained to 19% of those who drank >=14 drinks per week; P for trend <0.001). However, this trend remained significant only in blacks when analyses were stratified by race.
- Coronary calcification occurred more frequently in binge drinkers than in nonbinge drinkers (odds ratio 2.1).
- Adjusting analyses for coronary risk factors did not significantly affect the results.
This study found that alcohol use does not protect against—but increases—coronary calcification, though increases may be limited to blacks and occur primarily among binge drinkers. Unfortunately, the results are based on a very small number of cases (due to the young age of the cohort) and a definition of coronary calcification that is an inadequate marker for coronary disease. In any case, this and other studies suggest that moderate drinking's reported protection against heart attack may result more from its effects on coagulation than its effects on atherosclerosis.R. Curtis Ellison, MD
Pletcher MJ, Varosy P, Kiefe CI, et al. Alcohol consumption, binge drinking, and early coronary calcification: findings from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Epidemiol. 2005;161(5):423-433.