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American Journal of Epidemiology Advance Access originally published online on October 29, 2007
American Journal of Epidemiology 2008 167(1):34-41; doi:10.1093/aje/kwm274
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Alcohol Consumption and Lower Extremity Arterial Disease among Older Adults

The Cardiovascular Health Study

Kenneth J. Mukamal1, Margaret Kennedy2, Mary Cushman3, Lewis H. Kuller4, Anne B. Newman4, Joseph Polak5, Michael H. Criqui6 and David S. Siscovick7,8

1 Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
2 Hemostasis Thrombosis Laboratory, Western Pennsylvania Hospital, Pittsburgh, PA
3 Departments of Medicine and Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Burlington, VT
4 Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
5 Department of Radiology, New England Medical Center, Boston, MA
6 Departments of Medicine and Family and Preventive Medicine, School of Medicine, University of California, San Diego, CA
7 Department of Medicine, School of Medicine, University of Washington, Seattle, WA
8 Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA

Correspondence to Dr. Kenneth J. Mukamal, Beth Israel Deaconess Medical Center, 1309 Beacon Street, 2nd Floor, Brookline, MA 02446 (e-mail: kmukamal{at}bidmc.harvard.edu).

Received for publication October 30, 2006. Accepted for publication August 22, 2007.

Few studies of the relation of alcohol intake to lower-extremity arterial disease (LEAD) have included clinical events and objective measurements repeated longitudinally. As part of the Cardiovascular Health Study, a study of older adults from four US communities, 5,635 participants reported their use of beer, wine, and spirits yearly. Incident LEAD was identified by hospitalization surveillance. Technicians measured ankle-brachial index 6 years apart in 2,298 participants. A total of 172 cases of LEAD were documented during a mean of 7.5 years of follow-up between 1989 and 1999. Compared with abstention, the multivariable-adjusted hazard ratios were 1.10 (95% confidence interval (CI): 0.71, 1.71) for <1 alcoholic drink per week, 0.56 (95% CI: 0.33, 0.95) for 1–13 drinks per week, and 1.02 (95% CI: 0.53, 1.97) for ≥14 drinks per week (p for quadratic trend = 0.04). These relations were consistent within strata of sex, age, and apolipoprotein E genotype, and neither lipids nor inflammatory markers appeared to be important intermediates. Change in ankle-brachial index showed a similar relation (p for quadratic trend = 0.01). Alcohol consumption of 1–13 drinks per week in older adults may be associated with lower risk of LEAD, but heavier drinking is not associated with lower risk.

alcohol drinking; peripheral vascular diseases

Abbreviations: ABI, ankle-brachial index; CHS, Cardiovascular Health Study; CI, confidence interval; HDL, high density lipoprotein; HR, hazard ratio; LEAD, lower-extremity arterial disease


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