Alcohol intake, drinking patterns, and risk of nonfatal acute myocardial infarction in Costa Rica.
BACKGROUND
Moderate alcohol consumption is associated with a lower risk of myocardial infarction (MI). Whether alcohol is truly protective or whether the amount, type, or pattern of intake is the most important is still under debate.


OBJECTIVE
The purpose of this study was to determine whether alcohol intake and drinking patterns are associated with plasma lipids and the risk of MI in Costa Ricans, a population with a low intake of wine.


METHODS
We conducted a study of 2090 cases of a first nonfatal acute MI and 2090 population-based controls matched by age, sex, and residence in Costa Rica, a country with diet and lifestyles different from those of Western countries. Alcohol and dietary intakes were assessed by using validated questionnaires.


RESULTS
In a multivariate conditional regression model that controlled for other cardiovascular disease risk factors, the lowest risk of MI [odds ratio (OR) = 0.44; 95% CI: 0.31, 0.61] was observed for those who drank on average 3 drinks/wk (compared with lifelong abstainers). When we looked at the frequency of consumption, we found that the risk of MI among daily drinkers (OR = 0.64; 95% CI: 0.41, 1.01) was not significantly different (P = 0.23) from that of weekend drinkers (OR = 0.76; 95% CI: 0.59, 0.98) regardless of the amount consumed. HDL cholesterol increased with the amount and frequency of alcohol intake. Similar to a few other populations, apparent protection was observed at very low alcohol intakes.


CONCLUSIONS
Low to moderate consumption of alcohol 1-2 d/wk is independently associated with a reduced risk of MI.
Kabagambe
Edmond K
EK
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
Baylin
Ana
A
Ruiz-Narvaez
Edward
E
Rimm
Eric B
EB
Campos
Hannia
H
D000208:Acute Disease; D000428:Alcohol Drinking / Q000097:blood / Q000453:epidemiology; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D016001:Confidence Intervals; D003364:Costa Rica / Q000453:epidemiology; D004032:Diet; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology*; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013695:Temperance / Q000706:statistics & numerical data
D008076:Cholesterol, HDL