Per capita alcohol consumption and ischaemic heart disease mortality

Aim. To test the hypothesis that alcohol consumption is inversely related r o ischaemic heart disease (IHD) mortality, at the population level Most ind ividual-level studies find a reduced risk of IHD with a moderate level of a lcohol consumption, but it is as yet unknown whether this association also exists at the aggregate level, Measurements. The study, period was approxim ately 1950 to 1995; 14 EU countries and Norway were included. Time series a nalyses on differenced data were utilized, and age-standardized IHD mortali ty for men and women in the age groups 30-44, 45-59, 60-74 and 30-74 years was measured. The effects of alcohol (sales per capita) were controlled for a weighted lag of per capita sales of cigarettes. Findings. There was a ra ndom distribution of insignificant negative and positive alcohol effect est imates. A slight indication of a cardioprotective effect of alcohol among 3 0- to 44-year-old women in high consumption countries could be observed (si gnificant for Italy). Mean alcohol effect estimates were nearly exactly zer o (absent alcohol effect) among men and weakly positive among women. Becaus e changes in cigarette consumption were often significantly and positively related to subsequent changes ira IHD mortality, poor validity in the IHD t ime series cannot explain the unsystematic findings. Including a 6-year wei ghted lag of alcohol consumption changed the weak positive effect among wom en to an absent alcohol effect. A brief analysis of abstinence rates indica ted no particular relationship to IHD mortality. Conclusion. The alleged ca rdioprotective alcohol effect is absent at the population level, and great caution should be taken concerning alcohol policies for cardioprotective pu rposes.