title: Impact of level and patterns of alcohol drinking on coronary heart disease and stroke burden in Argentina.
abstract: BACKGROUND
  Deaths from cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke are expected to increase in Latin America. Moderate and regular alcohol consumption confers cardiovascular protection, while binge drinking increases risk. We estimated the effects of alcohol use on the number of annual CHD and stroke deaths and disability-adjusted life years (DALYs) in Argentina.
  
  
  METHODS
  Alcohol use data were obtained from a nationally representative survey (EnPreCosp 2011), and etiological effect sizes from meta-analyses of epidemiological studies. Cause-specific mortality rates were from the vital registration system.
  
  
  RESULTS
  There were 291,475 deaths in 2010 including 24,893 deaths from CHD and 15,717 from stroke. 62.7% of men and 38.7% of women reported drinking alcohol in the past year. All heavy drinkers (i.e. women who drank >20g/day and men who drank >40g/day of alcohol) met the definition of binge drinking and therefore did not benefit from cardioprotective effects. Alcohol drinking prevented 1,424 CHD deaths per year but caused 935 deaths from stroke (121 ischemic and 814 hemorrhagic), leading to 448 CVD deaths prevented (58.3% in men). Alcohol use was estimated to save 85,772 DALYs from CHD, but was responsible for 52,171 lost from stroke.
  
  
  CONCLUSIONS
  In Argentina, the cardioprotective effect of regular and moderate alcohol drinking is slightly larger than the harmful impact of binge drinking on CVD. However, considering global deleterious effects of alcohol in public health, policies to reduce binge drinking should be enforced, especially for young people. Studies are still needed to elucidate effects on cardiovascular health.
authors.affiliation: Institute for Clinical Effectiveness and Health Policy', Buenos Aires, Argentina.|National Scientific and Technical Research Council (CONICET)-Buenos Aires, Argentina.
authors.forename: Ariel Esteban
authors.identifier: http://orcid.org/0000-0003-4437-0073
authors.initials: AE
authors.lastname: Bardach
authors.affiliation: Institute for Clinical Effectiveness and Health Policy', Buenos Aires, Argentina.|National Scientific and Technical Research Council (CONICET)-Buenos Aires, Argentina.
authors.forename: Joaquín Enzo
authors.initials: JE
authors.lastname: Caporale
authors.affiliation: Institute for Clinical Effectiveness and Health Policy', Buenos Aires, Argentina.|National Scientific and Technical Research Council (CONICET)-Buenos Aires, Argentina.
authors.forename: Adolfo Luis
authors.initials: AL
authors.lastname: Rubinstein
authors.affiliation: Department of Global Health and Population-Department of Epidemiology, Harvard School of Public Health, Boston, United States of America.
authors.forename: Goodarz
authors.initials: G
authors.lastname: Danaei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000401:mortality; D001118:Argentina / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000209:etiology / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D018570:Risk Assessment / Q000379:methods; D020521:Stroke / Q000209:etiology / Q000401:mortality*