American Journal of Epidemiology Advance Access published online on January 10, 2007
American Journal of Epidemiology, doi:10.1093/aje/kwk063
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Smoking, Hypertension, Alcohol Consumption, and Risk of Abdominal Aortic Aneurysm in Men
1 Department of Nutrition, Harvard School of Public Health, Boston, MA
2 Division of Cardiac Surgery, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
3 Department of Epidemiology, Harvard School of Public Health, Boston, MA
4 The Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Correspondence to Dr. Eric B. Rimm, Department of Nutrition, Harvard School of Public Health, 655 Huntington Avenue, Building 2, Room 333a, Boston, MA 02115 (e-mail: eric.rimm{at}channing.harvard.edu).
Despite the known protective association between moderate alcohol consumption and ischemic heart disease, little is known about the effects of alcohol consumption on abdominal aortic aneurysms (AAA). The authors analyzed prospective, biennially updated data for a cohort of 39,352 US men from 1986 to 2002. The association of incident AAA diagnosis with alcohol consumption in grams per day was assessed at baseline and by using alcohol consumption data updated every 4 years, controlling for previously reported cardiovascular risk factors. During 576,374 person-years of follow-up, 376 newly diagnosed cases of AAA were demonstrated. After adjustment for other risk factors for AAA, including smoking, hypertension, and body mass index, alcohol consumption at baseline was independently associated with AAA diagnosis (p for trend = 0.03), with a maximum hazard ratio of 1.21 (95% confidence interval: 0.78, 1.87) for 
30.0 g (approximately 2 standard drinks) of daily alcohol consumption. This association was stronger when the updated alcohol consumption data were assessed rather than simply baseline exposure (p for trend = 0.02); the hazard ratio for the highest level of intake (30.0 g/day) was 1.65 (95% confidence interval: 1.03, 2.64). Small numbers limited analyses by beverage type, but liquor demonstrated the strongest positive association with AAA.
alcoholic beverages; aorta; aortic aneurysm; ethanol; risk factors; smoking
Abbreviations: AAA, abdominal aortic aneurysms; CI, confidence interval; METs, metabolic equivalents
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