Patterns of Alcohol Consumption and Myocardial Infarction Risk: Observations From 52 Countries in the INTERHEART Case–Control Study
Abstract
Background—: Although moderate alcohol use is associated with protection against myocardial infarction (MI), it is not known whether this effect is generalizable to populations worldwide. It is also uncertain whether differences in the pattern of alcohol use (and in particular heavy episodic consumption) between different regions negate any beneficial effect. Methods and Results—: We included 12 195 cases of first MI and 15 583 age- and sex-matched controls from 52 countries. Current alcohol use was associated with a reduced risk of MI (compared with nonusers: adjusted odds ratio, 0.87; 95% confidence interval, 0.80–0.94; P =0.001); however, the strength of this association was not uniform across different regions (region-alcohol interaction P <0.001). Heavy episodic drinking (≥6 drinks) within the preceding 24 hours was associated with an increased risk of MI (odds ratio, 1.4; 95% confidence interval, 1.1–1.9; P =0.01). This risk was particularly elevated in older individuals (for age >65 years: odds ratio, 5.3; 95% confidence interval, 1.6–18; P =0.008). Conclusions—: In most participants, low levels of alcohol use are associated with a moderate reduction in the risk of MI; however, the strength of this association may not be uniform across different countries. An episode of heavy drinking is associated with an increased risk of acute MI in the subsequent 24 hours, particularly in older individuals.
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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).”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [249]
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- Authors
- Leong, D. P., Smyth, A., Teo, K. K., McKee, M., Rangarajan, S., Pais, P., Liu, L., Anand, S. S., & Yusuf, S.
- Affiliations
- Population Health Research Institute (CA)
- Corresponding author
- Leong, Darryl P.
- ORCID
- Venue
- Circulation
- Published
- 2014-07-29
- Volume
- 130
- Issue
- 5
- Pages
- 390-398
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1988603791
- Cited by
- 141
- References
- 30
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 8 · 2023: 12 · 2022: 16 · 2021: 9 · 2020: 13 · 2019: 13 · 2018: 21 · 2017: 16 · 2016: 11 · 2015: 11 · 2014: 2
- FWCI
- 9.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- alcohol consumption, myocardial infarction, binge drinking, moderate drinking, alcohol and cardiovascular risk, older adults
- MeSH terms
- Aged, Alcohol Drinking, Female, Humans, Male, Middle Aged, Myocardial Infarction, Risk Factors, Global Health, Prevalence, Logistic Models, Odds Ratio, Case-Control Studies, Age Distribution, Sex Distribution, Risk Reduction Behavior, Racial Groups, Binge Drinking
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