Author + information
- Received August 4, 2009
- Revision received September 16, 2009
- Accepted October 14, 2009
- Published online March 30, 2010.
- Kenneth J. Mukamal, MD, MPH, MA⁎,⁎ (, )
- Chiung M. Chen, MA†,
- Sowmya R. Rao, PhD‡ and
- Rosalind A. Breslow, PhD¶
- ↵⁎Reprint requests and correspondence:
Dr. Kenneth J. Mukamal, BIDMC Division of General Medicine and Primary Care Research Program, 1309 Beacon Street, 2nd Floor, Brookline, Massachusetts 02446
Objectives The aim of this study was to determine the association of alcohol consumption and cardiovascular mortality in the U.S. population.
Background Alcohol consumption has been associated with a lower risk of cardiovascular disease in cohort studies, but this association has not been prospectively examined in large, detailed, representative samples of the U.S. population.
Methods We analyzed 9 iterations of the National Health Interview Survey, an annual survey of a nationally representative sample of U.S. adults between 1987 and 2000. Exposures of interest included usual volume, frequency, and quantity of alcohol consumption and binge drinking. Mortality was ascertained through linkage to the National Death Index through 2002. Relative risks were derived from random-effects meta-analyses of weighted, multivariable-adjusted hazard ratios for cardiovascular mortality from individual survey administrations.
Results Light and moderate volumes of alcohol consumption were inversely associated with cardiovascular mortality. Compared with lifetime abstainers, summary relative risks were 0.95 (95% confidence interval [CI]: 0.88 to 1.02) among lifetime infrequent drinkers, 1.02 (95% CI: 0.94 to 1.11) among former drinkers, 0.69 (95% CI: 0.59 to 0.82) among light drinkers, 0.62 (95% CI: 0.50 to 0.77) among moderate drinkers, and 0.95 (95% CI: 0.82 to 1.10) among heavy drinkers. The magnitude of lower risk was similar in subgroups of sex, age, or baseline health status. There was no simple relation of drinking pattern with risk, but risk was consistently higher among those who consumed ≥3 compared with 2 drinks/drinking day.
Conclusions In 9 nationally representative samples of U.S. adults, light and moderate alcohol consumption were inversely associated with CVD mortality, even when compared with lifetime abstainers, but consumption above recommended limits was not.
Computer programming and statistical support were provided through the Alcohol Epidemiologic Data System funded by contracts N0AA32007 and HHSN267200800023C from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The NIAAA reviewed and approved this report before submission. The findings and conclusions in this report are those of the authors and not necessarily those of the agency. Dr. Rao has received funding from GE Corporate Healthcare.
- Received August 4, 2009.
- Revision received September 16, 2009.
- Accepted October 14, 2009.
- American College of Cardiology Foundation