title: Alcohol consumption and risk of coronary heart disease in older adults: the Cardiovascular Health Study.
abstract: OBJECTIVE
  To evaluate several aspects of the relationship between alcohol use and coronary heart disease in older adults, including beverage type, mediating factors, and type of outcome.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Four U.S. communities.
  
  
  METHODS
  Four thousand four hundred ten adults aged 65 and older free of cardiovascular disease at baseline.
  
  
  METHODS
  Risk of incident myocardial infarction or coronary death according to self-reported consumption of beer, wine, and spirits ascertained yearly.
  
  
  RESULTS
  During an average follow-up period of 9.2 years, 675 cases of incident myocardial infarction or coronary death occurred. Compared with long-term abstainers, multivariate relative risks of 0.90 (95% confidence interval (CI)=0.71-1.14), 0.93 (95% CI=0.73-1.20), 0.76 (95% CI=0.53-1.10), and 0.58 (95% CI=0.39-0.86) were found in consumers of less than one, one to six, seven to 13, and 14 or more drinks per week, respectively (P for trend=.007). Associations were similar for secondary coronary outcomes, including nonfatal and fatal events. No strong mediators of the association were identified, although fibrinogen appeared to account for 9% to 10% of the relationship. The associations were statistically similar for intake of wine, beer, and liquor and generally similar in subgroups, including those with and without an apolipoprotein E4 allele.
  
  
  CONCLUSIONS
  In this population, consumption of 14 or more drinks per week was associated with the lowest risk of coronary heart disease, although clinicians should not recommend moderate drinking to prevent coronary heart disease based on this evidence alone, because current National Institute on Alcohol Abuse and Alcoholism guidelines suggest that older adults limit alcohol intake to one drink per day.
authors.affiliation: Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. kmukamal@bidmc.harvard.edu
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
authors.forename: Hyoju
authors.initials: H
authors.lastname: Chung
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Jenny
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
authors.forename: W T
authors.initials: WT
authors.lastname: Longstreth
authors.forename: Murray A
authors.initials: MA
authors.lastname: Mittleman
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Burke
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D001057:Apolipoproteins E / Q000235:genetics; D001515:Beer; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005838:Genotype; D015438:Health Behavior; D006801:Humans; D015994:Incidence; D008297:Male; D012111:Residence Characteristics; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014481:United States; D014920:Wine
chemical_list: D001057:Apolipoproteins E