Inverse Association between Alcohol Consumption and Mortality May Differ by Ethnicity

Moderate alcohol consumption is associated with a reduced risk of total mortality among Caucasian women, but whether it has the same protective effect for African-American women or all women with hypertension is unclear. This prospective study assessed the relationship between alcohol intake and mortality among 10,576 black and 105,610 white postmenopausal women participating in the Women’s Health Initiative. Women with a history of cancer or cardiovascular disease at baseline were excluded. Mean follow-up was 8 years.

• A total of 5608 women died over the follow-up period.

• After adjusting for potential confounders, moderate drinking (1 to <7 drinks per week) was associated with a lower risk of mortality among Caucasian women (hazard ratio [HR], 0.81) and all hypertensive women (HR, 0.76) compared with lifetime abstainers, but it had no significant protective effect for African-American women (HR, 0.94).

• Overall, in comparison with lifetime abstainers, current drinking of any amount from <1 drink per month to <14 drinks per week was associated with a lower risk of mortality among Caucasian women whether or not they had hypertension and among hypertensive African-American women (HR, 0.74), but it had no protective effect for nonhypertensive African-American women (HR, 1.31).

Comments:

There have been conflicting data as to whether the inverse association between moderate drinking, cardiovascular disease, and mortality seen among Caucasians also occurs among African Americans. As stated by the authors, the results among African-American women in this study may have been affected by the low prevalence of moderate drinking and the low mortality rate among lifetime abstainers without hypertension. Thus, the question of whether African Americans respond differently to alcohol than Caucasians in terms of mortality, and whether such differences, if they exist, relate to drinking pattern or biologic factors, remains unclear.

R. Curtis Ellison, MD

Reference:

Freiberg MS, Chang YF, Kraemer KL, et al. Alcohol consumption, hypertension, and total mortality among women. Am J Hypertens. 2009;22(11):1212–1218.