Impact of inflammation on the relationship among alcohol consumption, mortality, and cardiac events: the health, aging, and body composition study.
BACKGROUND
Uncertainty remains about the overall survival benefit of alcohol consumption and the mechanisms underlying the cardioprotective effect of light to moderate alcohol intake. Recent evidence suggests an anti-inflammatory effect of light to moderate alcohol consumption. We investigated the relationship of alcohol intake with all-cause mortality and cardiac events and evaluated whether this relationship is mediated or modified by inflammatory markers.


METHODS
The analysis included 2487 subjects, aged 70 to 79 years, without baseline coronary heart disease (CHD) or heart failure (HF), participating in the Health, Aging, and Body Composition study. All-cause mortality and incident cardiac events (CHD and HF) were detected during a mean follow-up of 5.6 years. Alcohol consumption and serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) were assessed at baseline.


RESULTS
A total of 397 participants died, and 383 experienced an incident cardiac event. Compared with never or occasional drinkers, subjects drinking 1 to 7 drinks per week had lower age-, sex-, and race-adjusted incidences of death (27.4 vs 20.1 per 1000 person-years, respectively) and cardiac events (28.9 vs 20.8 per 1000 person-years). After adjustment for confounders, compared with never or occasional drinkers, light to moderate drinkers (1-7 drinks per week) showed a decreased risk of death (hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.56-1.00) and cardiac events (HR, 0.72; CI, 0.54-0.97). Adjustment for potential mediators, and particularly inflammatory marker levels, did not affect the strength of this association.


CONCLUSIONS
Light to moderate alcohol consumption was associated with significantly lower rates of cardiac events and longer survival, independent of its anti-inflammatory effect.
Maraldi
Cinzia
C
Department of Aging and Geriatric Research, College of Medicine, Institute on Aging, University of Florida, 1329 SW 16th St, Gainesville, FL 32608, USA. Cmaraldi@aging.ufl.edu
Volpato
Stefano
S
Kritchevsky
Stephen B
SB
Cesari
Matteo
M
Andresen
Elena
E
Leeuwenburgh
Christiaan
C
Harris
Tamara B
TB
Newman
Anne B
AB
Kanaya
Alka
A
Johnson
Karen C
KC
Rodondi
Nicolas
N
Pahor
Marco
M
D000368:Aged; D000375:Aging / Q000502:physiology*; D000428:Alcohol Drinking / Q000097:blood / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D001823:Body Composition / Q000502:physiology*; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000097:blood / Q000209:etiology / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000097:blood* / Q000150:complications; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology
D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein