Alcohol and coronary heart disease: a perspective from the British Regional Heart Study.
BACKGROUND
A number of studies have shown that light or moderate alcohol intake is associated with a reduced incidence of coronary heart disease (CHD) compared with non-drinkers. There is controversy as to whether this is due to a specific protective effect of alcohol or whether the increased risk of CHD in non-drinkers is due to selective migration of high-risk subjects from drinking into non-drinking categories.


METHODS
A prospective study of men aged 40-59 years drawn at random from one general practice in each of 24 British towns, and followed for cardiovascular morbidity and all-cause mortality over a 9.5-year period.


RESULTS
There was a shallow U-shaped relationship between alcohol intake and all major CHD events and a strong inverse association with fatal CHD events. In men with no evidence of CHD at screening, despite a 28% (non-significant) reduction in the relative risk of fatal CHD events in men drinking 2-6 drinks/day, the difference in absolute rates of CHD between the drinking categories was small. Men with symptomatic CHD showed a strong inverse association between alcohol and all major CHD events and fatal CHD events. In men without a doctor diagnosis of cardiovascular disorder, those drinking 2-6 drinks/day showed a 34% (non-significant) reduction in relative risk of CHD death compared to occasional drinkers but little reduction in total cardiovascular mortality and no reduction in all-cause mortality.


CONCLUSIONS
These findings provide weak support for the protective effect of alcohol on CHD and no encouragement for regular moderate drinking on the grounds of benefit to health.
Department of Public Health, Royal Free Hospital School of Medicine, London, UK.
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D000328:Adult; D017677:Age Distribution; D000428:Alcohol Drinking; D016001:Confidence Intervals; D015986:Confounding Factors, Epidemiologic; D003327:Coronary Disease / Q000401:mortality* / Q000503:physiopathology; D004739:England; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D012907:Smoking; D012923:Social Class