Page last updated: November 19, 2015
Critique 173: A Large Study of the Association of Alcohol with the Risk of Acute Myocardial Infarction — 15 October 2015

This paper presents prospective data from a large population-based cohort from rural Norway, a region with typically light alcohol drinking and many abstainers who were not ex-heavy drinkers. It relates reported alcohol intake, assessed on two occasions, with the risk of developing an acute myocardial infarction (AMI). Its key findings are that, even in this very light-drinking population, drinkers had significantly lower risk (about 20% to 30%) of developing a MI than non-drinkers. As the authors conclude: “Light-to-moderate alcohol consumption was linearly associated with a decreased risk of AMI in a population in which abstaining from alcohol is not socially stigmatized. Our results suggest that frequent alcohol consumption is most cardioprotective and that this association is not driven by misclassification of former drinkers.”

As this was a rather homogeneous rural cohort without huge differences among subjects in socioeconomic status, it allows much better control of confounding. The fact that these results show essentially a continuous inverse association (rather than the usually seen “J-shaped” curve) is not unexpected given the very few heavy drinking subjects in this cohort. In addition to cardiovascular disease, the investigators also reported effects on total mortality, which showed a “J-shaped” curve.

Forum members considered this to be a very well-done study, and supports almost all previous research showing a protective effect of moderate drinking on the risk of coronary heart disease. The authors had good data on alcohol exposure and the occurrence of AMI. A key result from this study is that frequent light drinking, even less than an average of one drink/day, is associated with a significant decrease in the risk of coronary heart disease. Based on this study and most previous research, the clear message to the public remains: if you have no contraindications to alcohol use and decide to consume an alcoholic beverage, the healthiest approach is to drink frequently but in small amounts.

Reference: Gémes K, Janszky I, Laugsand LE, Lászlo KD, Ahnve S, Vatten LJ, Mukamal KJ. Alcohol consumption is associated with a lower incidence of acute myocardial infarction: results from a large prospective population-based study in Norway. J Intern Med 2015; doi: 10.1111/joim.12428.

For the full critique of this paper by members of the International Scientific Forum on Alcohol Research, please click here.
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