17 May 2016 In Cardiovascular System

OBJECTIVES: This study aimed to update the current information on alcohol consumption and evaluate the associations between drinking status and cardiovascular diseases in a general population from rural China.

METHODS: The study examined a total of 11,269 adults using a multi-stage cluster sampling method to select a representative sample of individuals 35years or older. Related medical histories were obtained using a standard questionnaire, and blood biochemical indexes were collected by well-trained personnel. Participants were asked for information about whether they regularly consumed alcohol, their average alcohol consumption per day, and the number of days per month that they consumed alcohol.

RESULTS: This population consisted of 75.8% non-drinkers, 7.5% moderate drinkers, and 16.7% heavy drinkers. And the mean alcohol consumption per day for the total population was 15.29+/-0.35g/d (women: 1.0+/-0.11g/d and men 32.5+/-0.69g/d, p<0.001). Multivariate logistic regression analysis showed that heavy drinkers had an approximately 1.3-fold and 1.7-fold greater risk for coronary heart disease and hypertension, respectively (OR: 1.252, 95% CI: 1.012 to 1.549; OR: 1.741, 95% CI: 1.519 to 1.994, respectively) compared with that of the non-drinking group. After fully adjusting the data for all variables, the data showed no significant association between moderate alcohol consumption and CHD, HT or ischemic stroke.

CONCLUSIONS: Alcohol consumption in rural populations is high, particularly in men. Heavy drinking is a risk factor for coronary heart disease and hypertension, but not for ischemic stroke. There was no significant association between moderate alcohol consumption and CHD, HT or ischemic stroke.

17 May 2016 In Cardiovascular System

BACKGROUND: Although alcohol consumption has long been considered as a risk factor for chronic disease, the relationship to cardiovascular disease (CVD) is complex and involves at least two dimensions: average volume of alcohol consumption and patterns of drinking. The objective of this contribution was to estimate the burden of CVD mortality caused by alcohol consumption.

METHODS RISK ASSESSMENT: modelling with alcohol-attributable CVD mortality as primary outcome. The mortality burden of ischaemic heart disease (IHD) and ischaemic stroke (IS) attributable to alcohol consumption was estimated using attributable-fraction methodology. Relative Risk (RR) data for IHD and IS were obtained from the most comprehensive meta-analyses (except for Russia and surrounding countries where alcohol RR data were obtained from a large cohort study). Age-group specific RRs were calculated, based on large studies. Data on mortality were obtained from the World Health Organization's Global Health Estimates and alcohol consumption data were obtained from the Global Information System on Alcohol and Health. Risk of former drinkers was modelled taking into account global differences in the prevalence of sick quitters among former drinkers. Alcohol-attributable mortality estimates for all other CVD causes except IHD and IS were obtained from the 2014 Global Status Report on Alcohol and Health.

RESULTS: An estimated 780,381 CVD deaths (441,893 and 338,490 CVD deaths among men and women respectively) were attributable to alcohol consumption globally in 2012, accounting for 1.4 % of all deaths and 26.6 % of all alcohol-attributable deaths. This is in contrast to the previously estimated 1,128,273 CVD deaths attributable to alcohol consumption globally, and represents a decrease of 30.8 % in alcohol-attributable CVD mortality and of 10.6 % in the global burden of all alcohol-attributable deaths.

CONCLUSIONS: When the most comprehensive and recent systematic reviews and meta-analyses are taken as bases, the net impact of alcohol consumption on CVD is lower than previously estimated.

22 March 2016 In Diabetes

BACKGROUND: Cardiometabolic index (CMI), calculated as a product of waist-to-height ratio and triglycerides-to-HDL cholesterol ratio, is a new index for discriminating diabetes mellitus. Patients with peripheral arterial disease (PAD) are prone to have other atherosclerotic diseases such as coronary artery disease and stroke. The purpose of this study was to clarify the relationships between CMI and indicators of atherosclerotic progression in patients with PAD.

METHODS: The subjects were 63 outpatients with PAD. Relationships of CMI with variables related to atherosclerotic progression were investigated using multivariate linear regression analysis and analysis of covariance with adjustment for age, sex and histories of smoking and alcohol drinking.

RESULTS: Log-transformed CMI was significantly correlated with mean intima-media thickness of the common carotid artery (IMT) (standardized regression coefficient: 0.350, p < 0.01) and % decrease in ankle-brachial systolic pressure index (ABI) after treadmill exercise (standardized regression coefficient: 0.365, p < 0.01). Mean IMT and % decrease in ABI by treadmill exercise were significantly higher (p < 0.01) in the group of the 3rd tertile for CMI than in the group of its 1st tertile (mean +/- SE: mean IMT (mm), 0.94 +/- 0.06 (1st tertile) vs. 0.94 +/- 0.06 (2nd tertile) vs. 1.19 +/- 0.06 (3rd tertile); % decrease in ABI, 14.1 +/- 3.4 [1st tertile] vs. 26.0 +/- 3.5 [2nd tertile] vs. 30.0 +/- 3.5 [3rd tertile]).

CONCLUSION: CMI was shown to be associated with the degrees of atherosclerosis in the common carotid artery and ischemia in leg arteries and is therefore a useful discriminator of atherosclerotic progression in patients with PAD.

22 March 2016 In Cardiovascular System

BACKGROUND: Although considerable research describes the cardiovascular effects of habitual moderate and heavy alcohol consumption, the immediate risks following alcohol intake have not been well characterized. Based on its physiological effects, alcohol may have markedly different effects on immediate and long-term risk.

METHODS AND RESULTS: We searched CINAHL, Embase, and PubMed from inception to March 12, 2015, supplemented with manual screening for observational studies assessing the association between alcohol intake and cardiovascular events in the following hours and days. We calculated pooled relative risks and 95% confidence intervals for the association between alcohol intake and myocardial infarction, ischemic stroke, and hemorrhagic stroke using DerSimonian and Laird random-effects models to model any alcohol intake or dose-response relationships of alcohol intake and cardiovascular events. Among 1056 citations and 37 full-text articles reviewed, 23 studies (29 457 participants) were included. Moderate alcohol consumption was associated with an immediately higher cardiovascular risk that was attenuated after 24 hours, and even protective for myocardial infarction and hemorrhagic stroke (approximately 2-4 drinks: relative risk=30% lower risk) and protective against ischemic stroke within 1 week (approximately 6 drinks: 19% lower risk). In contrast, heavy alcohol drinking was associated with higher cardiovascular risk in the following day (approximately 6-9 drinks: relative risk=1.3-2.3) and week (approximately 19-30 drinks: relative risk=2.25-6.2).

CONCLUSIONS: There appears to be a consistent finding of an immediately higher cardiovascular risk following any alcohol consumption, but, by 24 hours, only heavy alcohol intake conferred continued risk.

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