Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis
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OBJECTIVE: To conduct a comprehensive systematic review and meta-analysis of studies assessing the effect of alcohol consumption on multiple cardiovascular outcomes. DESIGN: Systematic review and meta-analysis. DATA SOURCES: A search of Medline (1950 through September 2009) and Embase (1980 through September 2009) supplemented by manual searches of bibliographies and conference proceedings. Inclusion criteria Prospective cohort studies on the association between alcohol consumption and overall mortality from cardiovascular disease, incidence of and mortality from coronary heart disease, and incidence of and mortality from stroke. Studies reviewed Of 4235 studies reviewed for eligibility, quality, and data extraction, 84 were included in the final analysis. RESULTS: The pooled adjusted relative risks for alcohol drinkers relative to non-drinkers in random effects models for the outcomes of interest were 0.75 (95% confidence interval 0.70 to 0.80) for cardiovascular disease mortality (21 studies), 0.71 (0.66 to 0.77) for incident coronary heart disease (29 studies), 0.75 (0.68 to 0.81) for coronary heart disease mortality (31 studies), 0.98 (0.91 to 1.06) for incident stroke (17 studies), and 1.06 (0.91 to 1.23) for stroke mortality (10 studies). Dose-response analysis revealed that the lowest risk of coronary heart disease mortality occurred with 1-2 drinks a day, but for stroke mortality it occurred with ≤1 drink per day. Secondary analysis of mortality from all causes showed lower risk for drinkers compared with non-drinkers (relative risk 0.87 (0.83 to 0.92)). CONCLUSIONS: Light to moderate alcohol consumption is associated with a reduced risk of multiple cardiovascular outcomes.
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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 [256]
Compared to nondrinkers, regular moderate consumption - up to ~2 drinks per day for men, ~1-1.5 drink per day for women - associates with lower incidence of CHD and diabetes, although not stroke.
“Conversely, compared to nondrinkers, regular moderate consumption – up to ~2 drinks per day for men, ~1-1.5 drink per day for women – associates with lower incidence of CHD and diabetes, although not stroke.288, 289”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [289]
Alcohol use exhibits a J-shape with all-cause mortality, with lowest risk observed between 1 drink/week and 1 drink/day, and higher risk thereafter.
“Alcohol use exhibits a “J-shape” with all-cause mortality, with lowest risk observed between 1 drink/week and 1 drink/day, and higher risk thereafter.289”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [289]
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Lifestyle modification in secondary prevention
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“Although moderate alcohol consumption may be protective against CVD mortality (Ronksley et al., 2011), alcohol abuse has been associated with increased CVD deaths (Bell et al.”
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From NAFLD to MAFLD: Aligning Translational In Vitro Research to Clinical Insights
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A nephrology guide to reading and using systematic reviews of observational studies
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Self-citation
- Authors
- Ronksley, P. E., Brien, S. E., Turner, B. J., Mukamal, K. J., & Ghali, W. A.
- Affiliations
- University of Calgary (CA)
- The University of Texas at San Antonio Health Science Center (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Ghali, W. A.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2011-02-22
- Volume
- 342
- Issue
- feb22 1
- Pages
- d671-d671
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC3043109
- OpenAlex
- W2109129984
- Cited by
- 1,610
- References
- 133
- Citations by year
- 2026: 61 · 2025: 71 · 2024: 96 · 2023: 93 · 2022: 107 · 2021: 111 · 2020: 128 · 2019: 125 · 2018: 116 · 2017: 116 · 2016: 114 · 2015: 145 · 2014: 102 · 2013: 97 · 2012: 97
- FWCI
- 13.12
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- Robert Wood Johnson Foundation
- Fondation pour la Recherche Médicale
- Canadian Institutes of Health Research
- 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, cardiovascular disease, cardiovascular mortality, coronary artery disease, stroke, stroke mortality, dose-response relationship, light to moderate drinking, all-cause mortality, health effects of alcohol
- MeSH terms
- Alcohol Drinking, Cardiovascular Diseases, Cause of Death, Coronary Disease, Humans, Prognosis, Prospective Studies, Risk Factors, Incidence, Stroke
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