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.
Comments:
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
Reference:
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.