26 January 2022 In Cardiovascular System

PURPOSE: To examine the acute and chronic effects of alcohol on blood pressure (BP) and the incidence of hypertension. We discuss the most current understanding of the mechanisms underlining these effects and their associations with the putative cardioprotective effects of consumption of low-to-moderate amounts of alcoholic beverages.

RECENT FINDINGS: A recent meta-analysis confirmed findings of experimental studies, demonstrating an acute biphasic effect of ethanol on BP, decreasing up to 12 h of ingestion and increasing after that. This effect is mediated by vagal inhibition and sympathetic activation. A meta-analysis found that chronic consumption of alcoholic beverages was associated with a high incidence of hypertension in men and women; it also found that, in women, the risk begins at moderate alcohol consumption. The risks of alcohol consumption are higher in Blacks than in Asians or Caucasians. The mechanism underlying the chronic effects of alcohol on BP, and particularly the differential effect on Blacks, is still unknown. Short-term trials showed that alcohol withdrawal promotes BP reduction; however, the long-term effectiveness of interventions that aim to lower BP through the restriction of alcohol consumption has not been demonstrated.

The harmful effects of alcohol on BP do not support the putative cardioprotective effect of low-to-moderate consumption of alcoholic beverages. The absence of a tangible mechanism of protection, and the possibility that this beneficial effect is biased by socioeconomic and other characteristics of drinkers and abstainers, calls into question the hypothesis that consuming low amounts of alcoholic beverages improves cardiovascular health. The evidence from investigations with various designs converge regarding the acute biphasic effect of ethanol on BP and the risk of chronic consumption on the incidence of hypertension, particularly for Blacks. These effects do not support the putative cardioprotective effect of consumption of low-to-moderate amounts of alcoholic beverages. Mechanisms of chronic BP increase and the demonstration of long-term benefits of reducing alcohol intake as a means to treat hypertension remain open questions.

26 January 2022 In Cardiovascular System

BACKGROUND: Population-based studies generally show J-shaped associations between alcohol intake and mortality from cardiovascular diseases (CVD). Little is known about alcohol and long-term mortality risk after myocardial infarction (MI).

OBJECTIVE: We examined alcohol intake in relation to all-cause, CVD and ischemic heart disease (IHD) mortality in Dutch post-MI patients of the Alpha Omega Cohort.

DESIGN: The analysis comprised 4,365 patients (60-80 y, 79% male) with an MI 0-2 g/d, n = 385), light (M: >2-10, F: >2-5 g/d, n = 1125), moderate (M: >10-30, F: >5-15 g/d, n = 1207) or heavy drinkers (M: >30, F: >15 g/d, n = 692). Hazard ratios (HRs) of mortality for alcohol intake were obtained from Cox models, adjusting for age, sex, education, smoking, BMI, physical activity and dietary factors.

RESULTS: Alcohol was consumed by 83% of males and 61% of females. During approximately 12 y of follow-up, 2,035 deaths occurred of which 903 from CVD and 558 from IHD. Compared to the (combined) reference group of non-drinkers and very light drinkers, HRs (95% CI) for all-cause mortality were 0.87 (0.78, 0.98), 0.85 (0.75, 0.96) and 0.91 (0.79, 1.04) in consecutive drinking categories. For CVD mortality, corresponding HRs were 0.80 (0.67, 0.96), 0.82 (0.69, 0.98) and 0.87 (0.70, 1.08). Findings for IHD mortality were similar. HRs did not materially change when non-drinkers or very light drinkers were taken as the reference, or after exclusion of former drinkers or patients with diabetes or poor/moderate self-rated health.

CONCLUSION: Light and moderate alcohol intake were inversely associated with mortality risk in stable post-MI patients. These observational findings should be cautiously interpreted in light of the total evidence on alcohol and health.Registration: The Alpha Omega Cohort is registered at Clinicaltrials.gov as NCT03192410.

26 January 2022 In Cardiovascular System

OBJECTIVE: This study aimed to investigate the association between alcohol consumption and the prevalence of stroke in Chinese adults aged 40 years and over.

METHOD: We conducted a cross-sectional analysis among 113,573 Chinese adults aged >/= 40 years in the China National Stroke Prevention Project (2014-2015) to examine correlations of alcohol consumption with the prevalence of stroke. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), controlling for various confounders, e.g., gender, age, smoking, physical activity and other health conditions.

RESULTS: Within the study population, a total of 12,753 stroke survivors were identified. The prevalence of light to moderate and of heavy alcohol consumption was 10.1% and 5.7% respectively. The multivariate logistic regression results show that light to moderate alcohol consumption was associated with reduced risk of stroke of all types [0.91 (95%CI: 0.85-0.97)] and of ischemic stroke [0.90 (0.84-0.97)]. No association was found between alcohol consumption and hemorrhagic stroke. Compared with abstainers, the adjusted ORs of all stroke were 0.83 (0.75-0.92) for those who drank 11-20 years, and no association was found between 1 and 10 years or over 20 years of drinking and risk of stroke.

CONCLUSIONS: These results indicate that light to moderate alcohol consumption may be protective against all and ischemic stroke, and heavy drinking was not significantly associated with risk of all stroke in China. No association between alcohol consumption and hemorrhagic stroke was found.

26 January 2022 In Cardiovascular System
Background Although previous studies have demonstrated a U-shaped relationship between alcohol and sudden cardiac death (SCD), there is a paucity of evidence on the role of alcohol specifically on incident ventricular arrhythmias (VAs). Objective The purpose of this study was to characterize associations of total and beverage-specific alcohol consumption with incident VA and SCD using data from the UK Biobank. Methods Alcohol consumption reported at baseline was calculated as UK standard drinks (8 g of alcohol) per week. Outcomes were assessed through hospitalization and death records. Alcohol consumption was modeled as restricted cubic splines in multivariate Cox regression models and corrected for regression dilution bias. Results We studied 408,712 middle-aged individuals (52.1% female) over a median follow-up time of 11.5 years. A total of 1733 incident VA events and 2044 SCDs occurred. For incident VA, no clear association was seen with total alcohol consumption. Although consumption of greater amounts of spirits was associated with increased VA risk, no other significant beverage-specific associations were observed. For SCD, a U-shaped association was seen for total alcohol consumption, such that consumption of
Page 9 of 44

Disclaimer

The authors have taken reasonable care in ensuring the accuracy of the information herein at the time of publication and are not responsible for any errors or omissions. Read more on our disclaimer and Privacy Policy.