SERUM HIGH-DENSITY-LIPOPROTEIN CHOLESTEROL, ALCOHOL, AND CORONARY MORTALITY IN MALE SMOKERS

Objective-To determine whether the increase in mortality from coronary heart disease with high concentrations (>1.75 mmol/1) of high density Lipoprotein cholesterol could be due to alcohol intake. Design-Cohort study. Setting-Placebo group of the alpha tocopherol, beta carotene c ancer prevention (ATBC) study of south western population in Finland. Participants-7052 male smokers aged 50-69 years enrolled to the ATBC s tudy in the 1980s. Main outcome measures-The relative and absolute rat es for clinically or pathologically verified deaths from coronary hear t disease for different concentrations of high density lipoprotein cho lesterol with and without stratification for alcohol intake. Similar r ates were also calculated for different alcohol consumption groups. Re sults-During the average follow up period of 6.7 years 258 men died fr om verified coronary heart disease. Coronary death rate steadily decre ased with increasing concentration of high density Lipoprotein cholest erol until a high concentration. An increase in the rate was observed above 1.75 mol/1. This increase occurred among those who reported alco hol intake. Mortality was associated with alcohol intake in a J shaped dose response, and those who reported consuming more than five drinks a day (heavy drinkers) had the highest death rate. Mortality was high er in heavy drinkers than in non-drinkers or light or moderate drinker s in all high density lipoprotein categories from 0.91 mmol/1 upward. Conclusions-Mortality from coronary heart disease increases at concent rations of high density lipoprotein cholesterol over 1.75 mmol/1. The mortality was highest among heavy drinkers, but an increase was found among light drinkers also.