If indeed the risk of coronary disease does not increase despite consuming alcohol at a level often classified as "hazardous," it is possible that the increase in cardiovascular disease from heavy drinking reported in many studies may be due to arrhythmias, cardiomyopathy, or other heart conditions that are not actually coronary artery disease.
Limitations to paper: Appropriate socio-economic variables were available for adjustment for confounding, with good assessments for alcohol intake, tobacco use, and drug abuse. However, sick quitters and unhealthy hazardous drinkers dying earlier than the healthy ones may have confounded the results. Further, unmeasured factors such as exercise and diet that were not adjusted for may have led to further confounding.
A key concern of Forum reviewers related to the method used to diagnose CHD in this analysis. Not only was it self-reported, but only 1.0% of cases stated that they had had a myocardial infarction, the primary "hard" criterion for CHD. Most reported angina pectoris, a "softer" criterion for coronary disease. Further, "arteriosclerosis" is a vague term and not one generally used in normal communication with patients. It could have referred to conditions other than CHD.
Most studies have found that frequent, light-to-moderate drinking is the healthiest approach for alcohol intake, and the average amount per week is an inadequate measure of intake. In this study, it is unclear whether or not the frequency of drinking was informative regarding CHD. Further, both rare, occasional, and regular drinkers who did not meet criteria for "hazardous drinking" were included in the "moderate" group, so it is not possible to separate daily drinkers from occasional drinkers.
The authors state that "Hazardous drinking was defined as exceeding sex-specific weekly limits as defined by the NIAAA (men, more that14 drinks o
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| Contact: R. Curtis Ellison ellison@bu.edu 508-333-1256 Boston University Medical Center Source:Eurekalert |