Does drinking pattern modify the effect of alcohol on the risk of coronary heart disease? Evidence from a meta-analysis
Abstract
Objective: To evaluate the strength of the evidence provided by epidemiological literature investigating drinking pattern as effect modifier of alcohol intake on the risk of coronary heart disease (CHD). Design: Meta-analysis of observational studies. Data sources: Medline, citation tracking, from 1966 to 2006. Review methods: Original studies investigating the amount of alcohol intake, combined with the frequency of alcohol consumption and/or pattern of alcohol drinking affecting the risk of CHD were extracted. Among them, cohort and case–control studies reporting sufficient data to perform statistical analyses and using people who abstained from alcohol as the reference were included. Results: Six (4 cohort and 2 case–control) out of 118 studies reviewed met the inclusion criteria. Compared with those who abstained from alcohol, regular heavy drinkers and heavy irregular or binge drinkers showed significantly different pooled relative risks of 0.75 (95% confidence interval 0.64 to 0.89) and 1.10 (1.03 to 1.17) respectively. The dose–response relation between the amount of alcohol intake and CHD risk was significantly different in regular and irregular drinkers. A J-shaped curve, with nadir around 28 grams of alcohol per week, and last protective dose of 131 grams per week, was obtained including drinkers who consumed alcohol for 2 days a week or less. Conversely, in people who consumed alcohol for more than 2 days a week a significant protective effect was seen even when drinking high amounts of alcohol. Conclusion: This meta-analysis suggests that binge and heavy irregular drinking modify the favourable effect of alcohol intake on the CHD risk. However, this conclusion should be taken with caution because of the small number of studies considered.
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The pattern of drinking is important: benefits are seen with moderate use across multiple days per week, not with high levels on a few days.
“In addition, the pattern of drinking is important: benefits are seen with moderate use across multiple days per week, not with high levels on a few days.293”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [293]
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- Authors
- Bagnardi, V, Zatonski, W., Scotti, L., La Vecchia, C., & Corrao, G.
- Affiliations
- University of Milan (IT)
- Mario Negri Institute for Pharmacological Research (IT)
- University of Milano-Bicocca (IT)
- Corresponding author
- Bagnardi, V
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2008-06-16
- Volume
- 62
- Issue
- 7
- Pages
- 615-619
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- OpenAlex
- W1984862834
- Cited by
- 165
- References
- 46
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 3 · 2022: 6 · 2021: 3 · 2020: 4 · 2019: 6 · 2018: 7 · 2017: 8 · 2016: 12 · 2015: 11 · 2014: 17 · 2013: 13 · 2012: 22
- FWCI
- 1.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Epidemiology & Community Health (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- 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 › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- coronary artery disease, alcohol consumption, drinking patterns, binge drinking, effect modification, dose-response relationship, J-curve
- MeSH terms
- Adolescent, Adult, Aged, Alcohol Drinking, Ethanol, Alcoholic Beverages, Australia, Canada, Central Nervous System Depressants, Coronary Disease, Denmark, Dose-Response Relationship, Drug, Female, Finland, Humans, Italy, Male, Middle Aged, Risk Factors, Russia, Time Factors, Young Adult
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