Quarterly Focus Issue: Prevention/Outcome
Clinical Research: Cardiovascular Risk
Alcohol Consumption and Cardiovascular Mortality Among U.S. Adults, 1987 to 2002

https://doi.org/10.1016/j.jacc.2009.10.056Get rights and content
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Objectives

The aim of this study was to determine the association of alcohol consumption and cardiovascular mortality in the U.S. population.

Background

Alcohol consumption has been associated with a lower risk of cardiovascular disease in cohort studies, but this association has not been prospectively examined in large, detailed, representative samples of the U.S. population.

Methods

We analyzed 9 iterations of the National Health Interview Survey, an annual survey of a nationally representative sample of U.S. adults between 1987 and 2000. Exposures of interest included usual volume, frequency, and quantity of alcohol consumption and binge drinking. Mortality was ascertained through linkage to the National Death Index through 2002. Relative risks were derived from random-effects meta-analyses of weighted, multivariable-adjusted hazard ratios for cardiovascular mortality from individual survey administrations.

Results

Light and moderate volumes of alcohol consumption were inversely associated with cardiovascular mortality. Compared with lifetime abstainers, summary relative risks were 0.95 (95% confidence interval [CI]: 0.88 to 1.02) among lifetime infrequent drinkers, 1.02 (95% CI: 0.94 to 1.11) among former drinkers, 0.69 (95% CI: 0.59 to 0.82) among light drinkers, 0.62 (95% CI: 0.50 to 0.77) among moderate drinkers, and 0.95 (95% CI: 0.82 to 1.10) among heavy drinkers. The magnitude of lower risk was similar in subgroups of sex, age, or baseline health status. There was no simple relation of drinking pattern with risk, but risk was consistently higher among those who consumed ≥3 compared with 2 drinks/drinking day.

Conclusions

In 9 nationally representative samples of U.S. adults, light and moderate alcohol consumption were inversely associated with CVD mortality, even when compared with lifetime abstainers, but consumption above recommended limits was not.

Key Words

alcohol
epidemiology
mortality

Abbreviations and Acronyms

CHD
coronary heart disease
CI
confidence interval
CVD
cardiovascular disease
HDL-C
high-density lipoprotein cholesterol
HR
hazard ratio
NCHS
National Center for Health Statistics
NHIS
National Health Interview Survey

Cited by (0)

Computer programming and statistical support were provided through the Alcohol Epidemiologic Data System funded by contracts N0AA32007 and HHSN267200800023C from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The NIAAA reviewed and approved this report before submission. The findings and conclusions in this report are those of the authors and not necessarily those of the agency. Dr. Rao has received funding from GE Corporate Healthcare.