Background Although heavy alcohol consumption increases total mortality, li
ght to moderate consumption decreases cardiovascular and all-cause mortalit
y in apparently healthy people. Since data are sparse on the relation of li
ght to moderate alcohol intake to mortality in patients with previous myoca
rdial infarction, we did a prospective study of mortality in men.
Methods Of 90 150 men in the Physicians' Health Study enrolment cohort who
provided information on alcohol intake and who had no history of cancer, st
roke, or liver disease, 5358 had a previous myocardial infarction. We estim
ated alcohol consumption by food-frequency questionnaire.
Findings During a mean follow-up of 5 years, 920 men died. After adjustment
for several potential confounders, moderate alcohol intake was associated
with a significant decrease in total mortality (p=0.016). Compared with men
who rarely or never drank alcohol, those who drank one to four drinks per
month had a relative risk for total mortality of 0.85 (95% CI 0.69-1.05); f
or two to four drinks per week, the relative risk was 0.72 (0.58-0.89); for
one drink per day 0.79 (0.64-9.96); and for two or more drinks per day 0.8
4 (0.55-1.26).
Interpretation Men with previous myocardial infarction who consume small to
moderate amounts of alcohol have a lower total mortality.