Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2012 Jul;107(7):1246-60.
doi: 10.1111/j.1360-0443.2012.03780.x. Epub 2012 Mar 21.

The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta-analysis

Michael Roerecke  1 , Jürgen Rehm
Affiliations
Review

The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta-analysis

Michael Roerecke et al. Addiction. 2012 Jul.

Abstract

Aims: Most, but not all, epidemiological studies suggest a cardioprotective association for low to moderate average alcohol consumption. The objective was to quantify the dose-response relationship between average alcohol consumption and ischaemic heart disease (IHD) stratified by sex and IHD end-point (mortality versus morbidity).

Methods: A systematic search of published studies using electronic databases (1980-2010) identified 44 observational studies (case-control or cohort) reporting a relative risk measure for average alcohol intake in relation to IHD risk. Generalized least-squares trend models were used to derive the best-fitting dose-response curves in stratified continuous meta-analyses. Categorical meta-analyses were used to verify uncertainty for low to moderate levels of consumption in comparison to long-term abstainers.

Results: The analyses used 38,627 IHD events (mortality or morbidity) among 957,684 participants. Differential risk curves were found by sex and end-point. Although some form of a cardioprotective association was confirmed in all strata, substantial heterogeneity across studies remained unexplained and confidence intervals were relatively wide, in particular for average consumption of one to two drinks/day.

Conclusions: A cardioprotective association between alcohol use and ischaemic heart disease cannot be assumed for all drinkers, even at low levels of intake. More evidence on the overall benefit-risk ratio of average alcohol consumption in relation to ischaemic heart disease and other diseases is needed in order to inform the general public or physicians about safe or low-risk drinking levels.

PubMed Disclaimer

Conflict of interest statement

Declarations of interest:

All other authors have no interests to declare.

Figures

Figure 1
Figure 1
Study selection process
Figure 2
Figure 2
Relative risk functions (solid lines, on the natural log scale) and corresponding 95% confidence intervals (dashed lines) for the dose-response relationship between average alcohol intake and risk of ischaemic heart disease (IHD), using only studies completely stratified by sex and endpoint, 1980–2010. 2a) IHD mortality in men, 2b) IHD morbidity in men, 2c) IHD mortality in women, 2d) IHD morbidity in women
Figure 2
Figure 2
Relative risk functions (solid lines, on the natural log scale) and corresponding 95% confidence intervals (dashed lines) for the dose-response relationship between average alcohol intake and risk of ischaemic heart disease (IHD), using only studies completely stratified by sex and endpoint, 1980–2010. 2a) IHD mortality in men, 2b) IHD morbidity in men, 2c) IHD mortality in women, 2d) IHD morbidity in women
Figure 2
Figure 2
Relative risk functions (solid lines, on the natural log scale) and corresponding 95% confidence intervals (dashed lines) for the dose-response relationship between average alcohol intake and risk of ischaemic heart disease (IHD), using only studies completely stratified by sex and endpoint, 1980–2010. 2a) IHD mortality in men, 2b) IHD morbidity in men, 2c) IHD mortality in women, 2d) IHD morbidity in women
Figure 2
Figure 2
Relative risk functions (solid lines, on the natural log scale) and corresponding 95% confidence intervals (dashed lines) for the dose-response relationship between average alcohol intake and risk of ischaemic heart disease (IHD), using only studies completely stratified by sex and endpoint, 1980–2010. 2a) IHD mortality in men, 2b) IHD morbidity in men, 2c) IHD mortality in women, 2d) IHD morbidity in women
Figure 3
Figure 3
Relative risk functions (solid lines, on the natural log scale) and corresponding 95% confidence intervals (dashed lines) for the dose-response relationship between average alcohol intake and risk of ischaemic heart disease (IHD), using also studies with combined sex or endpoint, 1980–2010. 3a) IHD mortality in men, 3b) IHD morbidity in men, 3c) IHD mortality in women, 3d) IHD morbidity in women
Figure 3
Figure 3
Relative risk functions (solid lines, on the natural log scale) and corresponding 95% confidence intervals (dashed lines) for the dose-response relationship between average alcohol intake and risk of ischaemic heart disease (IHD), using also studies with combined sex or endpoint, 1980–2010. 3a) IHD mortality in men, 3b) IHD morbidity in men, 3c) IHD mortality in women, 3d) IHD morbidity in women
Figure 3
Figure 3
Relative risk functions (solid lines, on the natural log scale) and corresponding 95% confidence intervals (dashed lines) for the dose-response relationship between average alcohol intake and risk of ischaemic heart disease (IHD), using also studies with combined sex or endpoint, 1980–2010. 3a) IHD mortality in men, 3b) IHD morbidity in men, 3c) IHD mortality in women, 3d) IHD morbidity in women
Figure 3
Figure 3
Relative risk functions (solid lines, on the natural log scale) and corresponding 95% confidence intervals (dashed lines) for the dose-response relationship between average alcohol intake and risk of ischaemic heart disease (IHD), using also studies with combined sex or endpoint, 1980–2010. 3a) IHD mortality in men, 3b) IHD morbidity in men, 3c) IHD mortality in women, 3d) IHD morbidity in women
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Rehm J, Baliunas D, Borges G, Graham K, Irving H, Kehoe T, et al. The relation between different dimensions of alcohol consumption and burden of disease: an overview. Addiction. 2010;105:817–843. - PMC - PubMed
    1. Mukamal KJ, Phillips RS, Mittleman MA. Beliefs, motivations, and opinions about moderate drinking: A cross-sectional survey. Fam Med. 2008;40:188–195. - PubMed
    1. Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen K. Alcohol and coronary heart disease: a meta-analysis. Addiction. 2000;95:1505–1523. - PubMed
    1. Costanzo S, Di Castelnuovo A, Donati MB, Iacoviello L, de Gaetano G. Alcohol consumption and mortality in patients with cardiovascular disease: a meta-analysis. J Am Coll Cardiol. 2010;55:1339–1347. - PubMed
    1. Maclure M. Demonstration of deductive metaanalysis - ethanol intake and risk of myocardial infarction. Epidemiol Rev. 1993;15:328–351. - PubMed