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Irregular Heavy Drinking Occasions and Risk of Ischemic Heart Disease: A Systematic Review and Meta-Analysis

Roerecke, M., Rehm, J.·2010·American Journal of Epidemiology

Abstract

Contrary to a cardioprotective effect of moderate regular alcohol consumption, accumulating evidence points to a detrimental effect of irregular heavy drinking occasions (>60 g of pure alcohol or > or =5 drinks per occasion at least monthly) on ischemic heart disease risk, even for drinkers whose average consumption is moderate. The authors systematically searched electronic databases from 1980 to 2009 for case-control or cohort studies examining the association of irregular heavy drinking occasions with ischemic heart disease risk. Studies were included if they reported either a relative risk estimate for intoxication or frequency of > or =5 drinks stratified by or adjusted for total average alcohol consumption. The search identified 14 studies (including 31 risk estimates) containing 4,718 ischemic heart disease events (morbidity and mortality). Using a standardized protocol, the authors extracted relative risk estimates and their variance, in addition to study characteristics. In a random-effects model, the pooled relative risk of irregular heavy drinking occasions compared with regular moderate drinking was 1.45 (95% confidence interval: 1.24, 1.70), with significant between-study heterogeneity (I(2) = 53.9%). Results were robust in several sensitivity analyses. The authors concluded that the cardioprotective effect of moderate alcohol consumption disappears when, on average, light to moderate drinking is mixed with irregular heavy drinking occasions.

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  • There is evidence for an increased risk associated with irregular heavy drinking, even in people who are on average light to moderate drinkers, for ischaemic heart disease, ischaemic stroke, all types of stroke, and different cardiovascular outcomes.

    “but there is also evidence for an increased risk associated with irregular heavy drinking, even in people who are on average light to moderate drinkers (ischaemic heart disease 247, 248, 249; ischaemic stroke 250; all types of stroke 251; different cardiovascular outcomes 252).”
  • In a meta-analysis, irregular binge drinking (>60 g pure alcohol or ≥5 drinks per occasion at least monthly) increased CHD risk by 45% (RR 1.45, 95% CI 1.24-1.70).

    “Patterns of alcohol consumption may be a particularly important determinant of the magnitude of the association—in a meta-analysis of 10 prospective cohort and 4 case-control studies, irregular “binge” drinking (>60 g of pure alcohol or >=5 drinks per occasion at least monthly) increased CHD risk by 45% (RR: 1.45; 95% CI: 1.24 to 1.70) (276).”

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1 of the 99 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Gmel G, Rehm J, Kuntsche E. Binge drinking in Europe: definitions, epidemiology, and consequences. Sucht. 2003; 49(2):105-116.
  2. Britton A, McKee M. The relation between alcohol and car- diovascular disease in Eastern Europe: explaining the paradox. J Epidemiol Community Health. 2000;54(5):328-332.
  3. Greenland S, Rothman KJ. Introduction to categorical statis- tics. In: Rothman KJ, Greenland S, Lash TL, eds. Modern Epidemiology. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2008:238-257.

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Authors
Roerecke, M., & Rehm, J.
Affiliations
Centre for Addiction and Mental Health (CA)
Venue
American Journal of Epidemiology
Published
2010-02-08
Volume
171
Issue
6
Pages
633-644
ISSN
  • 0002-9262 (ISSN-L)
  • 1476-6256
OpenAlex
W2033435847
Cited by
307
References
99
Citations by year
2026: 2 · 2025: 11 · 2024: 11 · 2023: 10 · 2022: 5 · 2021: 20 · 2020: 17 · 2019: 11 · 2018: 12 · 2017: 29 · 2016: 33 · 2015: 29 · 2014: 25 · 2013: 29 · 2012: 27
FWCI
3.58
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Kela
  • University of Toronto
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Pharmacology › Coffee research and impacts
Keywords
binge drinking, ischemic heart disease, alcohol consumption, moderate drinking, cardioprotection, alcohol intoxication, cardiovascular risk
MeSH terms
Alcohol Drinking, Alcoholic Intoxication, Humans, Regression Analysis, Risk Factors, Myocardial Ischemia

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