American Journal of Epidemiology Vol. 146, No. 6: 495-501
Copyright © 1997 by The Johns Hopkins University School of Hygiene and Public Health
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Alcohol Consumption and Coronary Heart Disease Morbidity and Mortality
1Addiction Research Foundation Toronto, Ontario, Canada
2Department of Preventive Medicine and Biostatistics, University of Toronto Toronto, Ontario, Canada
3Department of Internal Medicine and Division of Nutritional Sciences, University of Illinois Urbana, IL
4National Center for Health Statistics, Centers for Disease Control and Prevention Hyattsville, MD
Reprint requests to Dr. Jüurgen Rehm, Addiction Research Foundation, 33 Russell Street, Toronto, Ontario, Canada M5S 2S1
Alcohol consumption is associated with a reduced risk of coronary heart disease (CHD) but an increased risk of other causes of morbidity and mortality. It remains unclear whether there is an upper limit to a protective effect of alcohol intake on CHD risk. Whether there is a U- or an L-shaped relation between alcohol consumption and CHD incidence (hospitalization and mortality due to ischemic heart disease: International Classification of Diseases codes 410–414) is examined using the National Health and Nutrition Examination Survey I. Baseline data were collected in 1971–1975. Follow-up data through 1987 (14.6 years mean follow-up) were analyzed for 6,788 European-American males (n = 2,960) and females (n = 3,828) aged 40–75 years at baseline. Cox regression was used to assess the association between alcohol consumption and incidence of CHD. For females, an increased risk was found above 28 drinks per week relative to abstainers (relative risk = 2.6, 95% confidence interval 1.2–5.5), which was significant, but was based on small numbers. For males, no upturn in risk was found at higher intake. Mortality data supported these results. Sex differences should be explored further, since they are relevant to understanding causal mechanisms and public policy and prevention. Am J Epidemiol 1997;146:495-501.
alcohol drinking; coronory disease; incidence; morbidity; mortality; risk
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