ALCOHOL-CONSUMPTION AND CORONARY HEART-DISEASE MORBIDITY AND MORTALITY

Alcohol consumption is associated with a reduced risk of coronary hear t disease (CHD) but an increased risk of other causes of morbidity and mortality. It remains unclear whether there is an upper limit to a pr otective effect of alcohol intake on CHD risk. Whether there is a U-or an L-shaped relation between alcohol consumption and CHD incidence (h ospitalization and mortality due to ischemic heart disease: Internatio nal Classification of Diseases codes 410-414) is examined using the Na tional Health and Nutrition Examination Survey I. Baseline data were c ollected in 1971-1975. Follow-up data through 1987 (14.6 years mean fo llow-up) were analyzed for 6,788 European-American males (n = 2,960) a nd females (n = 3,828) aged 40-75 years at baseline. Cox regression wa s used to assess the association between alcohol consumption and incid ence of CHD. For females, an increased risk was found above 28 drinks per week relative to abstainers (relative risk = 2.6, 95% confidence i nterval 1.2-5.5), which was significant, but was based on small number s. For males, no upturn in risk was found at higher intake. Mortality data supported these results. Sex differences should be explored furth er, since they are relevant to understanding causal mechanisms and pub lic policy and prevention.