Disorders of Lipid Metabolism

DLM: Alcohol and Coronary Heart Disease (2007-2010)

• Intervention
  Does drinking alcohol containing beverages reduce the risk of CVD?

  • Conclusion
    Population and cohort studies, primarily of men, suggest 1-2 drinks of alcohol containing beverages/day are associated with reduced risk of cardiovascular disease. Excessive intakes are associated with increased all-cause mortality.
  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Does drinking alcohol containing beverages reduce the risk of CVD?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Di Castelnuovo A, Rotondo S, Iacoviello L, Donati MB, de Gaetano g. Meta-analysis of wine and beer consumption in relation to vascular risk. Circulation. 2002; 105:2836-2844.  
      • Goldberg IJ, Mosca L, Paino MR, Fisher EA. AHA Science Advisory: Wine and your heart: a science advisory for healthcare professionals for the Nutrition Committee, Council on Epidemiology and Prevention, and Council on Cardiovascular Nursing of the American Heart Association. Circulation. 2001; 103: 472-475.
      • Gronbaek M, Deis A, Sorensen TI, Becker U, Schnohr P, Jensen G. Mortality associated with moderate intakes of wine, beer or spirits. BMJ. 1995;310: 1,165-1,169.
      • Hein HO, Suadicani P, Gyntelberg F. Alcohol consumption, serum low density lipoprotein cholesterol concentration, and risk of ischaemic heart disease: six year follow up in the Copenhagen Study. BMJ. 1996;312:736-741.
      • Mukamal KJ, Conigrave KM, Mittleman MA, Camargo CA, Stampfer MJ, Willett WC, Rimm EB. Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. N Engl J Med. 2003; 348:1 09-18.
      • Rimm EB, Giovanncci EL, Willett WC, Colditz GA, Ascherio A, Rosner B, Stamfer MJ. Prospective study of alcohol consumption and risk of coronary disease in men. Lancet. 1991; 338 (8,765): 464-468.
      • Romelsjo A, Leifman A. Association between alcohol consumption and mortality, mycardial infarction and stroke in a 25 year follow of 48,618 young Swedish men. BMJ. 1999; 319: 821-822.
      • Sesso HD, Stampfer MJ, Rosner B, Hennekens CH, Manson JE, Gazaine JM. Seven year changes in alcohol consumption and subsequent risk of cardiovascular disease in men. Arch Int Med. 2000;160:2605-2612.
      • Tanasescu M, Hu FB, Willet WC, Stampfer MJ. Alcohol consumption and risk of coronary heart disease among men with type 2 diabetes mellitus. J Am Coll Cardiol 2001; 38: 1,836-1,842.
      • Trevisan M, Schisterman E, Mennotti A, Farchi G, Conti S, Risk Factor and Life Expectancy Group. Drinkilng pattern and mortality: the Italian Risk Factor and Life Expectancy Pooling Project. Am Epidemiol 2001; 11:312-319.
  Is there evidence that drinking patterns are predictive of risk of coronary heart disease?

  • Conclusion

    The ADA Disorders of Lipid Metabolism workgroup concurs with the following statement and grade from the USDA Nutrition Evidence Library (NEL):

    Insufficient evidence was available to determine if drinking patterns were predictive of risk of coronary heart disease (CHD), although there was moderate evidence to suggest that heavy or binge drinking is detrimental.

     

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the relationship between alcohol intake and coronary heart disease?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Bagnardi, V., Zatonski, W., Scotti, L., La Veccha, C., & Corrao G. (2008). Does drinking pattern modify the effect of alcohol on the risk of coronary heart disease?: Evidence from a meta-analysis. Journal of Epidemiology and Community Health, 62, 615-619.
      • Britton A, McKee M. The relation between alcohol and cardiovascular disease in
        Eastern Europe: explaining the paradox. J Epidemiol Community Health. 2000
        May;54(5):328-32. Review.
      • Cleophas TJ. Wine, beer and spirits and the risk of myocardial infarction: a systematic review. Biomed  Pharmacother. 1999;53(9):417-23.
      • Corrao, G., Rubbiati, L., Bagnardi, V., Zambon, A. & Poikolainen, K. (2000). Alcohol and coronary heart disease: a meta-analysis. Addiction, 95, 1505-1523.
      • Di Castelnuovo A, Rotondo S, Iacoviello L, Donati MB, De Gaetano G. Meta-analysis of wine and beer consumption in relation to vascular risk. Circulation. 2002 Jun 18;105(24):2836-44.
      • Rimm EB, Williams P, Fosher K, Criqui M, Stampher MJ. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ 1999; 319: 1523-1528.
  What is the relationship between alcohol intake and coronary heart disease?

  • Conclusion

    The ADA Disorders of Lipid Metabolism workgroup concurs with the following statement and grade from the USDA Nutrition Evidence Library (NEL):

    Strong evidence consistently demonstrates that compared to non-drinkers, individuals who drink moderately have lower risk of coronary heart disease (CHD).

    
    

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the relationship between alcohol intake and coronary heart disease?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Bagnardi, V., Zatonski, W., Scotti, L., La Veccha, C., & Corrao G. (2008). Does drinking pattern modify the effect of alcohol on the risk of coronary heart disease?: Evidence from a meta-analysis. Journal of Epidemiology and Community Health, 62, 615-619.
      • Britton A, McKee M. The relation between alcohol and cardiovascular disease in
        Eastern Europe: explaining the paradox. J Epidemiol Community Health. 2000
        May;54(5):328-32. Review.
      • Cleophas TJ. Wine, beer and spirits and the risk of myocardial infarction: a systematic review. Biomed  Pharmacother. 1999;53(9):417-23.
      • Corrao, G., Rubbiati, L., Bagnardi, V., Zambon, A. & Poikolainen, K. (2000). Alcohol and coronary heart disease: a meta-analysis. Addiction, 95, 1505-1523.
      • Di Castelnuovo A, Rotondo S, Iacoviello L, Donati MB, De Gaetano G. Meta-analysis of wine and beer consumption in relation to vascular risk. Circulation. 2002 Jun 18;105(24):2836-44.
      • Rimm EB, Williams P, Fosher K, Criqui M, Stampher MJ. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ 1999; 319: 1523-1528.