The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta‐analysis
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Aims Most, but not all, epidemiological studies suggest a cardioprotective association for low to moderate average alcohol consumption. The objective was to quantify the dose–response relationship between average alcohol consumption and ischaemic heart disease (IHD) stratified by sex and IHD end‐point (mortality versus morbidity). Methods A systematic search of published studies using electronic databases (1980–2010) identified 44 observational studies (case–control or cohort) reporting a relative risk measure for average alcohol intake in relation to IHD risk. Generalized least‐squares trend models were used to derive the best‐fitting dose–response curves in stratified continuous meta‐analyses. Categorical meta‐analyses were used to verify uncertainty for low to moderate levels of consumption in comparison to long‐term abstainers. Results The analyses used 38 627 IHD events (mortality or morbidity) among 957 684 participants. Differential risk curves were found by sex and end‐point. Although some form of a cardioprotective association was confirmed in all strata, substantial heterogeneity across studies remained unexplained and confidence intervals were relatively wide, in particular for average consumption of one to two drinks/day. Conclusions A cardioprotective association between alcohol use and ischaemic heart disease cannot be assumed for all drinkers, even at low levels of intake. More evidence on the overall benefit–risk ratio of average alcohol consumption in relation to ischaemic heart disease and other diseases is needed in order to inform the general public or physicians about safe or low‐risk drinking levels.
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Beneficial effects of non-heavy drinking are seen mainly for ischaemic diseases, i.e. ischaemic heart disease and ischaemic stroke.
“Beneficial effects are seen mainly for ischaemic diseases, i.e. ischaemic heart disease and ischaemic stroke 256, 257.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [257]
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Britton, A. R. (2004) · European Journal of Public Health · doi:10.1093/eurpub/14.2.217-b · Cited by 2 · see citing works
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Research works printed but not linked: 1
- [33]Greenland S Rothman KJ Rothman KJ Greenland S Lash TL Introduction to Categorical Statistics Modern Epidemiology 3 Philadelphia, US Lippincott Williams & Wilkens 2008 238 257
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The relationship between different dimensions of alcohol use and the burden of disease—an update
Rehm, J., Gmel, G. E., Gmel, G., Hasan, O. S. M., Imtiaz, S., Popova, S., Probst, C., Roerecke, M., Room, R., Samokhvalov, A. V., et al. (2017) · Addiction · doi:10.1111/add.13757 · Cited by 1,204 · see citing works
Self-citationWood, A. M., Kaptoge, S., Butterworth, A. S., Willeit, P., Warnakula, S., Bolton, T., Paige, E., Paul, D. S., Sweeting, M., Burgess, S., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30134-x · Cited by 1,188 · see citing works
Millwood, I. Y., Walters, R. G., Mei, X. W., Guo, Y., Yang, L., Bian, Z., Bennett, D. A., Chen, Y., Dong, C., Hu, R., et al. (2019) · The Lancet · doi:10.1016/s0140-6736(18)31772-0 · Cited by 514 · see citing works
Chronic diseases and conditions related to alcohol use
Shield, K. (2013) · Alcohol Research: Current Reviews · doi:10.35946/arcr.v35.2.06 · Cited by 488 · see citing works
“Despite the increased risk for ischemic heart disease at higher levels of alcohol consumption noted in observational studies (see Roerecke and Rehm 2012 for the most up-to-date meta-analysis), there was not enough evidence for a detrimental effect of alcohol consumption on ischemic heart disease…”
BackgroundMethodResultInfluentialKontis, V., Mathers, C. D., Rehm, J., Stevens, G. A., Shield, K. D., Bonita, R., Riley, L. M., Poznyak, V., Beaglehole, R., & Ezzati, M. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60616-4 · Cited by 418 · see citing works
Self-citationRoerecke, M., & Rehm, J. (2014) · BMC Medicine · doi:10.1186/s12916-014-0182-6 · Cited by 342 · see citing works
Self-citationAlcohol use disorders and mortality: a systematic review and meta-analysis
Roerecke, M., & Rehm, J. (2013) · Addiction · doi:10.1111/add.12231 · Cited by 326 · see citing works
Self-citationA narrative review of alcohol consumption as a risk factor for global burden of disease
Rehm, J., & Imtiaz, S. (2016) · Substance Abuse Treatment, Prevention, and Policy · doi:10.1186/s13011-016-0081-2 · Cited by 177 · see citing works
Self-citationReduction of drinking in problem drinkers and all-cause mortality
Rehm, J., & Roerecke, M. (2013) · Alcohol and Alcoholism · doi:10.1093/alcalc/agt021 · Cited by 122 · see citing works
Self-citationReduced Drinking in Alcohol Dependence Treatment, What Is the Evidence?
Mann, K., Aubin, H.-J., & Witkiewitz, K. (2017) · European Addiction Research · doi:10.1159/000481348 · Cited by 93 · see citing works
Quantifying the contribution of alcohol to cardiomyopathy: A systematic review
Rehm, J., Hasan, O. S. M., Imtiaz, S., & Neufeld, M. (2017) · Alcohol · doi:10.1016/j.alcohol.2017.01.011 · Cited by 92 · see citing works
Self-citationAlcohol Intake Revisited: Risks and Benefits
Roerecke, M., & Rehm, J. (2012) · Current Atherosclerosis Reports · doi:10.1007/s11883-012-0277-5 · Cited by 58 · see citing works
Self-citationCan We Establish Causality with Statistical Analyses? The Example of Epidemiology
Frick, U., & Rehm, J. (2016) · Wiley Series in Probability and Statistics · doi:10.1002/9781118947074.ch17 · Cited by 14 · see citing works
Self-citation
- Authors
- Roerecke, M., & Rehm, J.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- Corresponding author
- Roerecke, Michael
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2012-03-21
- Volume
- 107
- Issue
- 7
- Pages
- 1246-1260
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- PMC
- PMC3348338
- OpenAlex
- W2163997450
- Cited by
- 249
- References
- 107
- Citations by year
- 2026: 8 · 2025: 8 · 2024: 13 · 2023: 9 · 2022: 14 · 2021: 12 · 2020: 20 · 2019: 13 · 2018: 18 · 2017: 24 · 2016: 26 · 2015: 26 · 2014: 28 · 2013: 22 · 2012: 8
- FWCI
- 3.93
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA016644, P50AA005595)
- 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
- alcohol consumption, ischemic heart disease, cardioprotection, dose-response relationship, sex differences, heart disease mortality, low-risk drinking
- MeSH terms
- Adult, Aged, Alcohol Drinking, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Morbidity, Prognosis, Cohort Studies, Case-Control Studies, Myocardial Ischemia, Sex Distribution
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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