Adopting Moderate Alcohol Consumption in Middle Age Reduces Cardiovascular Risk
Despite the known cardiovascular (CV) benefits of moderate alcohol consumption, initiation of alcohol use in middle age to obtain those benefits is not recommended. To assess whether adopting moderate alcohol use in middle age would lower CV risk, King et al. examined a cohort of men and women aged 45–64 years who were participating in a 10-year observational study.
Among the 7697 participants who were nondrinkers at baseline and had no existing CV disease at 6-year follow-up, 6075 were available for assessment at the end of the study. A fatal or non-fatal CV event between years 6 and 10 was assessed as the primary outcome. Moderate alcohol use was classified as <7 drinks per week for women or <14 drinks per week for men. Authors calculated the reduction of CV events and mortality after 4 years controlling for known CV risk factors in the 6075 available participants.
- Overall, a 38% reduction (6.9% versus 10.7%) in CV events was found among new moderate drinkers compared with nondrinkers (OR 0.62; 95% CI, 0.40–0.95).
- New drinkers experienced no change in overall mortality.
- New drinkers had significantly lower LDL (123.5 mg/dl versus 127.8 mg/dl) and higher HDL (54.7 mg/dl versus 51.7 mg/dl) cholesterol than nondrinkers.
Despite the relatively brief follow-up, the CV benefit noted was impressive and adds to similar cohort data involving men. Given the cohort study design and the risks of alcohol-related injury or malignancy, these data are insufficient to change current recommendations. Nonetheless, they do enhance the case for a randomized controlled trial to resolve whether to recommend moderate alcohol consumption to those without past alcohol problems to yield cardioprotective benefits.Jeffrey H. Samet, MD, MA, MPH
King DE, Mainous AG 3rd, Geesey ME. Adopting moderate alcohol consumption in middle age: subsequent cardiovascular events. Am J Med. 2008;121(3):201–206.