Alcohol intake and future incidence of hypertension in a general Japanese population: the Hisayama study

BACKGROUND: The question remains as to whether light to moderate alcohol intake is associated with an increased risk of hypertension. METHODS: In 1978, a total of 1101 residents (433 men and 668 women) in a subrural community, Hisayama, in Japan, aged 40 years or more, with normal blood pressure, who were free from cardiovascular disease, were enrolled in a 10-year follow-up study. Inquiries regarding regular drinking were made in an interview based on a self-administered questionnaire. RESULTS: During the follow-up, 101 men and 166 women developed hypertension (blood pressure > or =140/90 mm Hg or use of antihypertensive drugs). The age-adjusted incidence of hypertension among current male drinkers increased significantly even with a light intake of alcohol (<23 g of ethanol per day). In women, the incidence was also significantly higher in drinkers than in nondrinkers. In multivariate analysis, alcohol intake, in addition to age and body mass index, remained a significant independent risk factor for hypertension in men, but not in women. In men, all three categories of current drinking were found to be significant risk factors for the development of hypertension after adjustment for age and body mass index [relative risk (RR), 2.00; 95% confidence interval (CI), 1.07-3.76 for light drinking compared with nondrinking; RR, 2.60; 95% CI, 1.50-4.49 for moderate drinking (23-45 g per day); and RR, 2.24; 95% CI, 1.26-3.99 for heavy drinking (> or =46 g/day)]. CONCLUSIONS: Our results suggest that alcohol intake, even light drinking, is a predictor of future hypertension among Japanese men.     

Age-dependent association of alcohol drinking with pulse pressure

BACKGROUND: Wide pulse pressure is a potent risk factor for atherosclerotic disease, and hypertension is induced by habitual alcohol drinking. This concise study investigated whether age affects the relationship between alcohol drinking and pulse pressure. METHODS: The participants were 99 661 male workers (20-69 years old) who had received periodic health check-ups. The mean levels of pulse pressure and blood pressure were compared among three different groups divided by the average amount of daily alcohol intake (nondrinkers; light drinkers, < 30 g ethanol/day; heavy drinkers, >or= 30 g ethanol/day) in each age group. RESULTS: The mean pulse pressure was decreased in the thirties and forties age groups compared with that in the twenties age group, and then was increased with advance of age in the fifties and sixties age groups. Pulse pressure was significantly wider in heavy drinkers than in nondrinkers and light drinkers in all age groups, and the difference between pulse pressure of nondrinkers and that of heavy drinkers was greater in the fifties and sixties age groups than in the younger groups. Pulse pressure in light drinkers was significantly wider than that in nondrinkers in the fifties and sixties age groups but was not different from that in nondrinkers in the twenties to forties age groups. CONCLUSIONS: Association of alcohol intake with pulse pressure is dependent on the amount of alcohol and is stronger in the elderly. Age as well as amount of alcohol intake should therefore be taken into account when the influence of alcohol drinking on pulse pressure is considered.     

Inverse association of light-to-moderate alcohol drinking with cardiometabolic index in men with diabetes mellitus

Aims

Cardiometabolic index (CMI), calculated as the product of waist-to-height ratio and triglycerides-to-HDL cholesterol ratio, has been proposed as a discriminator of diabetes and has been reported to be associated with progression of atherosclerosis. The purpose of this study was to determine the relationship between alcohol drinking and CMI in men with diabetes.

Blood HDL cholesterol levels influence association of alcohol intake with blood pressure in young men but not in middle-aged men

BACKGROUND: Both blood pressure and HDL cholesterol are affected by alcohol drinking. However, it has not been determined whether association of alcohol drinking with blood pressure varies depending on blood HDL level. METHODS: The subjects were male workers aged 20 to 29 year and 50 to 59 year (n = 21,301), representing young and middle ages, respectively, who had received periodic health checkup examinations. The subjects were divided into tertile groups by serum HDL level, and they were further divided into 3 subgroups based on the average daily alcohol intake [nondrinkers, light drinkers (<30 g of ethanol per day) and heavy drinkers (30 g or more of ethanol per day)]. Blood pressure and incidence of high blood pressure were compared among the 3 alcohol subgroups in each age and HDL group. RESULTS: In the lowest HDL tertile of 20 to 29-year-old subjects, systolic and diastolic blood pressure and incidences of high systolic and diastolic blood pressure were not significantly different among the 3 alcohol subgroups. In the middle and highest HDL tertiles of the twenties age group, systolic and diastolic blood pressure was significantly higher in heavy drinkers than in nondrinkers, and incidences of high systolic and diastolic blood pressure were significantly higher in drinkers than in nondrinkers. On the other hand, in all HDL tertile groups of 50 to 59-year-old subjects, blood pressure was significantly higher in light drinkers and heavy drinkers than in nondrinkers, and incidences of high systolic and diastolic blood pressure were significantly higher in drinkers than in nondrinkers. CONCLUSIONS: The results suggest that blood pressure of middle-aged men is elevated by alcohol drinking independently of blood HDL level and is more sensitive to drinking than is blood pressure of young men.     

The joint association of average volume of alcohol and binge drinking with hazardous driving behaviour and traffic crashes

BACKGROUND: Previous studies on alcohol-related road safety have not assessed the joint impact of average volume of alcohol and binge drinking. AIM: To examine the joint and separate association of average volume of alcohol and binge drinking with hazardous driving behaviour and traffic crashes. METHODS: Data were drawn from telephone interviews conducted in the period 2000-2005, with 12 037 individuals representative of the population aged 18-64 years in the Madrid region, Spain. The threshold between average moderate and heavy volumes was 40 g of alcohol/day in men and 24 g/day in women. Binge drinking was defined as intake of >or= 80 g of alcohol in men and >or= 60 g in women, during any drinking occasion in the preceding 30 days. Individuals were classified into the following categories: (i) non-drinkers; (ii) moderate drinkers with no binge drinking (MDNB); (iii) moderate drinkers with binge drinking (MDB); (iv) heavy drinkers with no binge drinking (HDNB); and (v) heavy drinkers with binge drinking (HDB). Analyses were performed using logistic regression, with adjustment for sex, age and educational level. FINDINGS: Frequency of inadequate seat-belt use increased progressively across categories of alcohol consumption, with odds ratio (OR) 1 in non-drinkers, 1.19 [95% confidence interval (CI) 1.06-1.33] in MDNB, 1.69 (1.41-2.03) in MDB, 1.68 (1.24-2.29) in HDNB and 2.41 (1.83-3.18) in HDB (P for trend <0.001). Compared with MDNB, alcohol-impaired driving was also more frequent in MDB (OR 7.43; 95% CI: 5.52-10.00), HDNB (OR 7.31; 95% CI: 4.37-12.25) and in HDB (OR 15.50; 95% CI: 10.62-22.61). Lastly, compared with non-drinkers, frequency of traffic crashes increased progressively across categories of alcohol consumption (P for trend=0.028), although it only reached statistical significance in HDB (OR 2.01; 95% CI: 1.00-4.09). CONCLUSIONS: Self-reported average volume of alcohol and binge drinking are both associated with self-reported hazardous driving behaviour and traffic crashes. The strength of the association is greater when average heavy consumption and binge drinking occur jointly.     

Alcohol consumption and prognosis in patients with left ventricular systolic dysfunction after a myocardial infarction

OBJECTIVES: We assessed the influence of alcohol intake on the development of symptomatic heart failure (HF) in patients with left ventricular (LV) dysfunction after a myocardial infarction (MI). BACKGROUND: In contrast to protection from coronary heart disease, alcohol consumption has been linked to cardiodepressant effects and has been considered contraindicated in patients with HF. METHODS: The Survival And Ventricular Enlargement (SAVE) trial randomized 2231 patients with a LV ejection fraction (EF) <40% following MI to an angiotensin-converting enzyme inhibitor or placebo. Patients were classified as nondrinkers, light-to-moderate drinkers (1 to 10 drinks/week), or heavy drinkers (>10 drinks/week) based on alcohol consumption reported at baseline. The primary outcome was hospitalization for HF or need for an open-label angiotensin-converting enzyme inhibitor. Analyses were repeated using alcohol consumption reported three months after MI. RESULTS: Nondrinkers were older and had more comorbidities than light-to-moderate and heavy drinkers. In univariate analyses, baseline light-to-moderate alcohol intake was associated with a lower incidence of HF compared with nondrinkers (hazard ratio [HR] 0.71; 95% confidence interval [CI] 0.57 to 0.87), whereas heavy drinking was not (HR 0.91; 95% CI 0.67 to 1.23). After adjustment for baseline differences, light-to-moderate baseline alcohol consumption no longer significantly influenced the development of HF (light-to-moderate drinkers HR 0.93; 95% CI 0.75 to 1.17; heavy drinkers HR 1.25; 95% CI 0.91 to 1.72). Alcohol consumption reported three months after the MI similarly did not modify the risk of adverse outcome. CONCLUSIONS: In patients with LV dysfunction after an MI, light-to-moderate alcohol intake either at baseline or following MI did not alter the risk for the development of HF requiring hospitalization or an open-label angiotensin-converting enzyme inhibitor.     

Relationship of light to moderate alcohol consumption and risk of hypertension in Japanese male office workers

BACKGROUND: A close relationship between alcohol consumption and hypertension has been established, but the effect of light to moderate alcohol consumption on blood pressure (BP) remains unclear. METHODS: A total of 5275 Japanese male office workers aged 23 to 59 years partook in a survey. Subjects were classified as nondrinkers or current drinkers who averaged less than 12, 12 to 22, 23 to 45, or > or =46 g/day of ethanol. BPs were measured at annual health examinations from May 1996 through May 2000. A total of 3784 hypertension-free (systolic BP <140 mm Hg, diastolic BP <90 mm Hg, no medication for hypertension, and no history of hypertension) men were observed for 4 years. Men in whom hypertension (systolic BP > or =140 mm Hg, diastolic BP > or =90 mm Hg, or both or receipt of antihypertensive medication) was found during repeated surveys were defined as incident cases of hypertension. RESULTS: After controlling for potential predictors of hypertension, systolic and diastolic BP levels and the incidence of hypertension were lowest in nondrinkers in all three age ranges (23-35, 36-47, and 45-59 years) and increased in a dose-dependent manner as alcohol consumption increased. For individuals aged 23 to 35 years, systolic and diastolic BP levels and the incidence of hypertension were significantly higher among those who drank an average of > or =23 g/day of ethanol than among nondrinkers. For those aged 36 to 59, the diastolic BP level was significantly higher among those who drank any alcohol at all than among nondrinkers, and the systolic BP level and the incidence of hypertension were significantly higher among those who drank an average of > or =12 g/day of ethanol than among nondrinkers. CONCLUSIONS: Light to moderate alcohol consumption seems to have an important influence on BP in both young and middle-aged Japanese men.     

Effect of the interaction between steatosis and alcohol intake on liver fibrosis progression in chronic hepatitis C

OBJECTIVES: Liver steatosis is a common histopathological finding in patients infected with hepatitis C virus. Patients with chronic hepatitis C having both steatosis and factors causing oxidative stress may be at a higher risk of fibrogenesis. In a subset of patients with a definite date of contamination, our study aimed to assess the potential synergistic interaction between steatosis and factors likely to induce oxidative stress-namely, alcohol intake, iron overload, and drugs. METHODS: Out of 700 anti-HCV-positive screened patients, 142 untreated patients with liver biopsy and with one known risk factor were selected. Liver fibrosis, inflammation, and necrosis were graded according to the Knodell score, and steatosis as moderate to severe if more than 30% of hepatocytes were affected. Drinkers were defined as having daily mean alcohol intakes of more than 30 g in men and 20 g in women. RESULTS: In multivariate analysis, two factors were independently associated with extensive fibrosis: the degree of severity of piecemeal necrosis (OR = 3.27, CI = 1 .17-9.16) and a combination of moderate to severe steatosis and alcohol intake (OR = 7.02, CI = 1.12-44). The median progression rate of fibrosis was about twice as high among drinkers with steatosis than among drinkers without steatosis or nondrinkers with or without steatosis (0.25 vs 0. I vs 0.13 vs 0.08, respectively; p = 0.02). Independent parameters significantly associated with moderate to severe steatosis were body mass index (OR = 1.13, CI = 1.02-1.26) and infection with genotype 3 (OR = 5.5, CI = 1.88-16), but not alcohol consumption. CONCLUSIONS: As well as the key role of the severity of piecemeal necrosis, the study underlines the synergistic interaction between steatosis and even low alcohol consumption as a contributory factor in extensive liver fibrosis.     

Inverse association between excessive alcohol drinking and cardiometabolically healthy status in middle-aged men with and without overweight and obesity

Aims

The aim of this study was to clarify the relationship between drinking and metabolically healthy status in men with normal weight, overweight and obesity.

Type of alcohol consumed and mortality from all causes, coronary heart disease, and cancer

BACKGROUND: Although the J-shaped relation between alcohol intake and mortality has been reproduced in many large cohort studies, the question of whether the effects of beer, wine, and spirits differ remains controversial. OBJECTIVE: To examine the relation between intake of different types of alcohol and death from all causes, coronary heart disease, and cancer. DESIGN: Pooled cohort studies in which intake of beer, wine, and spirits; smoking status; educational level; physical activity; and body mass index were assessed at baseline. SETTING: Copenhagen, Denmark. PARTICIPANTS: 13 064 men and 11 459 women 20 to 98 years of age. MEASUREMENTS: Number of deaths and time to death from all causes, coronary heart disease, and cancer during follow-up. RESULTS: During 257 859 person-years of follow-up, 4833 participants died. J-shaped relations were found between total alcohol intake and mortality at various levels of wine intake. Compared with nondrinkers, light drinkers who avoided wine had a relative risk for death from all causes of 0.90 (95% CI, 0.82 to 0.99) and those who drank wine had a relative risk of 0.66 (CI, 0. 55 to 0.77). Heavy drinkers who avoided wine were at higher risk for death from all causes than were heavy drinkers who included wine in their alcohol intake. Wine drinkers had significantly lower mortality from both coronary heart disease and cancer than did non-wine drinkers (P = 0.007 and P = 0.004, respectively). CONCLUSION: Wine intake may have a beneficial effect on all-cause mortality that is additive to that of alcohol. This effect may be attributable to a reduction in death from both coronary heart disease and cancer.     

Alcohol use, physical performance, and functional limitations in older men

OBJECTIVES: To describe associations between recent alcohol intake, physical performance, and functional limitations in older men. DESIGN: Cross-sectional study. SETTING: Six U.S. clinical centers. PARTICIPANTS: Five thousand nine hundred sixty-two men aged 65 and older. MEASUREMENTS: Self-reported functional limitations; problem drinking history (>or=2 positive responses on the CAGE questionnaire); history of sustained excessive drinking (history of consumption of >or=5 drinks/day on most days); and alcohol intake categorized by drinks/week (0=abstainers, n=2,116; < 1=intermittent, n=739); 1 to <7= light, n=1,563; 7 to <14=low-moderate, n=848; 14 to <21 =high-moderate, n=459; and >or=21=heavy, n=237). Grip strength, leg power, chair stand, and walking tests were completed during a standard examination. RESULTS: After age adjustment, men with low-moderate or high-moderate intake generally performed 3% to 5% better on physical performance tests than abstainers; heavy drinkers performed similarly to abstainers. These associations lessened yet tended to remain significant after multivariate adjustment. Men with low-moderate alcohol intake had the lowest odds of reporting a limitation in instrumental activities of daily living (multivariate-adjusted odds ratio (OR)=0.52, 95% confidence interval (CI)=0.39-0.69) compared to abstainers; similar odds were seen for high-moderate and heavy use. The association between alcohol intake and self-reported physical limitation was U-shaped, with the highest odds of physical limitation in abstainers (OR=1.0, referent) and heavy users (OR=0.88, 95% CI=0.58-1.36) and the lowest odds in low-moderate users (OR=0.62, 95% CI=0.46-0.95). CONCLUSION: Moderate alcohol intake was associated with modestly better physical performance and lower odds of reporting a functional limitation in older men.     

Alcohol consumption and coronary atherosclerosis progression--the Stockholm Female Coronary Risk Angiographic Study

OBJECTIVE: To assess the association of alcohol intake with progression of coronary atherosclerosis. Although moderate drinkers have a lower risk of coronary heart disease than abstainers, the relation of alcohol use and coronary atherosclerosis has not been well studied. METHODS AND RESULTS: In the Stockholm Female Coronary Risk Angiographic Study, we evaluated 103 women, aged 65 years or younger, hospitalized with acute myocardial infarction or unstable angina pectoris who underwent serial quantitative coronary angiography 3-6 months following their index event and repeated an average of 3 years and 3 months (range 2-5 years) later. Individual alcoholic beverage consumption was assessed by a standardized questionnaire. We used mixed model analysis to estimate the effect of alcohol consumption on progression of coronary atherosclerosis, as measured by mean luminal diameter change, controlling for age, smoking, body-mass index, education, physical activity, index cardiac event, menopausal status, diabetes, and history of dyslipidemia. Of the 93 women with complete information on alcohol intake, 14 consumed no alcohol (abstainers), 55 consumed up to 5 g of alcohol per day (light drinkers), and 24 consumed more than 5 g of alcohol per day (moderate drinkers). Coronary atherosclerosis progressed by a multivariate-adjusted average of 0.138 mm (95% confidence interval (CI): 0.027-0.249) among abstainers, 0.137 mm (95% CI: 0.057-0.217) among light drinkers, and -0.054 mm (95% CI: -0.154 to 0.047) among moderate drinkers (P < 0.001). The inverse association persisted in analyses stratified by index event. No beverage type appeared to confer particular benefit. CONCLUSIONS: Among middle-aged women with coronary heart disease, moderate alcohol consumption (over 5 g/day) was protective of coronary atherosclerosis progression.     

Alcohol Consumption and the Risk of Hypertension in Men and Women: A Systematic Review and Meta‐Analysis

J Clin Hypertens (Greenwich). 2012;14:792–798. ©2012 Wiley Periodicals, Inc. Heavy alcohol intake increases the risk of hypertension, but the relationship between light to moderate alcohol consumption and incident hypertension remains controversial. The authors sought to analyze the dose‐response relationship between average daily alcohol consumption and the risk of hypertension via systematic review and meta‐analysis. Electronic databases were searched for prospective control studies examining quantitative measurement of alcohol consumption and biological measurement of outcome. The primary endpoint was the risk of developing hypertension based on alcohol consumption. The level of alcohol consumption from each study was assigned to categorical groups based on the midpoint of their alcohol consumption classes to make possible the comparison of heterogeneous classification of alcohol intake. A total of 16 prospective studies (33,904 men and 193,752 women) were included in the analysis. Compared with nondrinkers, men with alcohol consumption with <10 g/d and 11 to 20 g/d had a trend toward increased risk of hypertension (relative risk [RR], 1.03; 95% confidence interval [CI], 0.94–1.13; P=.51) and (RR, 1.15; 95% CI, 0.99–1.33; P=.06), respectively, whereas a significantly increased risk of hypertension was found with heavy alcohol consumption of 31 to 40 g/d (RR, 1.77; 95% CI, 1.39–2.26; P<.001) and >50 g/d (RR, 1.61; 95% CI, 1.38–1.87; P<.001). Among women, the meta‐analysis indicated protective effects at <10 g/d (RR, 0.87; 95% CI, 0.82–0.92; P<.001) and a trend toward decreased risk of hypertension with alcohol consumption 11 to 20 g/d (RR, 0.9; 95% CI, 0.87–1.04; P=.17), whereas a significantly increased risk of hypertension was indicated with heavy alcohol consumption of 21 to 30 g/d (RR, 1.16; 95% CI, 0.91–1.46; P=.23) and 31 to 40 g/d (RR, 1.19; 95% CI, 1.07–1.32; P=.002). In men, heavy alcohol consumption is associated with increased risk of hypertension, whereas there is a trend toward increased risk of hypertension with low and moderate alcohol consumption. The relationship between alcohol consumption and hypertension is J‐shaped in women. Limiting alcohol intake should be advised for both men and women.     

Moderate Alcohol Consumption Protects Against Colorectal Adenomas in Smokers

Background Although some studies have shown an association between alcohol consumption and colorectal adenomas, the effect of moderate alcohol consumption is not well defined, nor is the interaction between alcohol and smoking. Aim To investigate the relationship between different levels of alcohol consumption and colorectal adenomas and to determine whether smoking modifies this relationship. Methods Eligible patients who underwent a complete colonoscopy were included (179 cases and 466 controls). Alcohol consumption was obtained from a lifestyle questionnaire. Patients were divided into three groups: (1) Abstainers: 0 drinks/week; (2) Moderate drinkers: > 0 to <7 drinks/week; (3) Heavy drinkers: > 7 drinks/week. Odds ratios (OR) were calculated using logistic regression, controlling for gender, age, body mass index, use of non-steroidal anti-inflammatory medications. Results were stratified by the number of years smoked. Results The proportion of patients with adenomas was 29.6% in abstainers, 22.1% in moderate drinkers, and 36.7% in heavy drinkers. The relationship between alcohol consumption and colorectal adenomas varied significantly by smoking history. For individuals who had never smoked, heavy drinkers were at significantly increased odds of having an adenoma compared to moderate drinkers (OR 3.08; 95% CI: 1.50–6.32), while no difference was seen for abstainers (OR 0.99; 95% CI: 0.52–1.89). Similarly, among individuals who had smoked 1–14 years, heavy drinkers were at increased odds of having an adenoma compared to moderate drinkers (OR 2.61; 95% CI: 1.04–6.51), and no difference was seen for abstainers (OR 1.02; 95% CI: 0.33–3.10). Somewhat unexpectedly, among individuals who had smoked for 15 or more years, abstainers were at increased odds of having an adenoma compared to moderate drinkers (OR 2.04; 95% CI: 0.91–4.59), while heavy drinkers were not at increased odds of having an adenoma (OR 0.73; 95% CI: 0.27–1.97). Conclusions Consumption of less than seven alcohol drinks per week does not increase the risk of having a colorectal adenoma. We found evidence in this study that moderate alcohol consumption among long-term smokers may potentially decrease the risk of an adenoma compared to abstainers.     

Alcohol Consumption Among Older Adults in Primary Care

Background Alcohol misuse is a growing public health concern for older adults, particularly among primary care patients. Objectives To determine alcohol consumption patterns and the characteristics associated with at-risk drinking in a large sample of elderly primary care patients. Design Cross-sectional analysis of multisite screening data from 6 VA Medical Centers, 2 hospital-based health care networks, and 3 Community Health Centers. Participants Patients, 43,606, aged 65 to 103 years, with scheduled primary care appointments were approached for screening; 27,714 (63.6%) consented to be screened. The final sample of persons with completed screens comprised 24,863 patients. Measurements Quantity and frequency of alcohol use, demographics, social support measures, and measures of depression/anxiety. Results Of the 24,863 older adults screened, 70.0% reported no consumption of alcohol in the past year, 21.5% were moderate drinkers (1–7 drinks/week), 4.1% were at-risk drinkers (8–14 drinks/week), and 4.5% were heavy (>14 drinks/week) or binge drinkers. Heavy drinking showed significant positive association with depressive/anxiety symptoms [Odds ratio (OR) (95% CI): 1.79 (1.30, 2.45)] and less social support [OR (95% CI): 2.01 (1.14, 2.56)]. Heavy drinking combined with binging was similarly positively associated with depressive/anxiety symptoms [OR (95%): 1.70 (1.33, 2.17)] and perceived poor health [OR (95% CI): 1.27 (1.03, 1.57)], while at-risk drinking was not associated with any of these variables. Conclusions The majority of participants were nondrinkers; among alcohol users, at-risk drinkers did not differ significantly from moderate drinkers in their characteristics or for the 3 health parameters evaluated. In contrast, heavy drinking was associated with depression and anxiety and less social support, and heavy drinking combined with binge drinking was associated with depressive/anxiety symptoms and perceived poor health.     

The metabolic syndrome and high C-reactive protein: prevalence and differences by sex in a southern-European population-based cohort

BACKGROUND: To evaluate the prevalence of the metabolic syndrome (MS) and its components in a population-based cohort, and to analyse the association between gender, environmental conditions, C-reactive protein (CRP), and the syndrome. METHODS: Out of 1877 subjects aged 45-64, who represented all the patients of six family physicians, representative of the sanitary districts of Asti (north-western Italy), 88% accepted to participate in an interview on personal habits, and several clinical and laboratory measurements. RESULTS: The MS (National Cholesterol Education Program criteria) was present in 24% of males and 22% of females. Males had a significantly higher percentage of hyperglycaemia, hypertension, hypertriglyceridemia, whereas females had a higher prevalence of central obesity and low HDL-cholesterol. In a multiple logistic regression model, the MS was significantly associated with increasing age, BMI, and >30 g/day alcohol intake (OR = 1.42; 95% CI 1.27-1.58), and negatively to higher education level (OR = 0.52; 95% CI 0.28-0.99) and moderate exercise (OR = 0.65; 95% CI 0.57-0.76). CRP levels are highly correlated to BMI and the components of the syndrome. The association between CRP and the MS remains significant in women only, in a multivariate analysis, after multiple adjustments (OR = 1.73; 95% CI 1.42-2.11). Higher CRP levels, correlated to smoking and, inversely, to alcohol intake, identify a further 12% of the cohort at higher cardiovascular risk. CONCLUSIONS: The MS affects more than 20% of this middle-aged cohort, but more than 30%, with higher CRP levels are at high cardiovascular risk. Healthier lifestyle habits are inversely associated with the MS and CRP levels, suggesting the need for strategies and their implementation in the general population.     

Alcohol consumption and metabolic syndrome among Shanghai adults： A randomized multistage stratified cluster sampling investigation

AIM： To examine the relations of alcohol consumption to the prevalence of metabolic syndrome in Shanghai adults. METHODS： We performed a cross-sectional analysis of data from the randomized multistage stratified cluster sampling of Shanghai adults, who were evaluated for alcohol consumption and each component of metabolic syndrome, using the adapted U.S. National Cholesterol Education Program criteria. Current alcohol consumption was defined as more than once of alcohol drinking per month. RESULTS： The study population consisted of 3953 participants （1524 men） with a mean age of 54.3 ± 12.1 years. Among them, 448 subjects （11.3%） were current alcohol drinkers, including 405 males and 43 females. After adjustment for age and sex, the prevalence of current alcohol drinking and metabolic syndrome in the general population of Shanghai was 13.0% and 15.3%, respectively. Compared with nondrinkers, the prevalence of hypertriglyceridemia and hypertension was higher while the prevalence of abdominal obesity, low serum high-density-lipoprotein cholesterol （HDL-C） and diabetes mellitus was lower in subjects who consumed alcohol twice or more per month, with a trend toward reducing the prevalence of metabolic syndrome. Among the current alcohol drinkers, systolic blood pressure, HDL-C, fastingplasma glucose, and prevalence of hypertriglyceridemia tended to increase with increased alcohol consumption. However, low-density-lipoprotein cholesterol concentration, prevalence of abdominal obesity, low serum HDL-C and metabolic syndrome showed the tendency to decrease. Moreover, these statistically significant differences were independent of gender and age.CONCLUSION： Current alcohol consumption is associated with a lower prevalence of metabolic syndrome irrespe- ctive of alcohol intake （g/d）, and has a favorable influence on HDL-C, waist circumference, and possible diabetes mellitus. However, alcohol intake increases the likelihood of hypertension, hypertriglyceridemia and hyperglycemia. The clinical signi     

Alcohol drinking and risk of hospitalization for heart failure with and without associated coronary artery disease

Myocardial damage from heavy alcohol intake can cause the heart failure (HF) syndrome, but the relation of lighter alcohol intake to HF has rarely been studied. We examined the risk of HF hospitalization among 126,236 subjects who supplied data about alcohol during health examinations from 1978 to 1985. Among 2,594 subjects who were subsequently hospitalized for HF, record review established an association between coronary artery disease (CAD) and HF (CAD-HF) in 1,559 patients. Among the remaining 1,035 subjects who had HF (non-CAD-HF), we attempted determination of preponderant etiologic and contributory factors. Analyses used Cox models that were controlled for 7 covariates, with usual alcohol intake studied categorically compared with that in subjects who did not drink alcohol. Heavier drinkers (> or =3 drinks/day) but not light to moderate drinkers had increased risk of non-CAD-HF; e.g., relative risk for subjects who reported > or =6 drinks/day was 1.7 (95% confidence interval 1.1 to 2.6). This association of non-CAD-HF with heavy drinking was limited to subsets with cardiomyopathy or of unclear preponderant etiology. Alcohol drinking was inversely related to risk of CAD-HF (e.g., at 1 to 2 drinks/day, relative risk 0.6, 95% confidence interval 0.5 to 0.7), with consistency across subgroups of age, gender, ethnicity, education, smoking status, interval to diagnosis, and presence or absence of baseline heart disease or systemic hypertension. Moderate drinking was inversely related to non-CAD-HF only in subjects who had diabetes mellitus (n = 252). In conclusion, heavy, but not light, alcohol drinking is associated with increased risk of non-CAD-HF and that apparent protection by alcohol drinking against CAD-HF risk provides confirmation of a protective effect of alcohol against CAD.     

Alcohol consumption and mortality in Alameda County

The association between level of alcohol consumption and 15-year mortality, focusing particularly on the possible protective effect of light drinking compared to abstention, was studied in a representative population sample of 6928 residents of Alameda County, California. Because abstainers differ from light, moderate and heavy drinkers on a number of demographic, physical, and psychosocial characteristics, the role of these as confounders of the alcohol/mortality association was examined. Using multiple logistic models, the mortality experience of abstainers, moderate drinkers, heavy drinkers and very heavy drinkers was compared with that of light drinkers. Among men only, very heavy drinkers were at significantly greater risk of death from all causes than were light drinkers (OR = 2.5, p less than 0.01). Neither abstainers nor other drinkers were at significantly higher risk of death from ischemic heart disease than were light drinkers. This pattern of results persisted with adjustment for 11 covariates of alcohol consumption in addition to age.     

Exercise tolerance and alcohol intake. Blood pressure relation

The relations of systolic and diastolic blood pressures to alcohol intake and exercise tolerance levels in 15,612 men and 3,855 women were investigated. Alcohol intake was assessed by questionnaire and stratified into seven levels for men and six for women according to the ounces of ethanol consumed per week. Exercise tolerance was determined by maximal treadmill exercise testing and was categorized into six age-specific by sex-specific levels. Both systolic and diastolic blood pressure were significantly related to both alcohol intake and exercise tolerance levels in both men and women. These relations, which were positive for alcohol and negative for exercise tolerance, remained after covariance adjustment for age, body mass index, and cigarette smoking. Alcohol intake was not significantly correlated with exercise tolerance. The relation of blood pressure to alcohol was not linear because the blood pressure of moderate consumers of alcohol tended to be slightly lower than that of nondrinkers. Higher blood pressure was found only in drinkers whose ethanol intake exceeded 9.5 ounces (approximately 285 ml or 19 drinks) per week. However, heavy drinkers in high exercise tolerance categories had no higher blood pressure than nondrinkers in low exercise tolerance groups. Exercise tolerance or physiological fitness appears to be important in quantifying the relation between alcohol intake and blood pressure and should be considered in describing this relation.