Abstract
In France there are few cardiac deaths in spite of high animal fat intake. France and Italy have the highest overall intake of alcohol in the world. Obviously, there is an inverse association between coronary heart disease (CHD) and alcohol intake in these countries. Although in the past decade several-large scale population studies have confirmed the beneficial effect of alcohol on CHD, these studies may not have been sensitive to control all the confounding variables.
No one so far has explored the possibility that the French may be protected by their low level of life stress. In 1993 we conducted a case-control study (n = 118) to examine psychological variables in a group of Dutch males under sixty years of age, before and after acute myocardial infarction (MI). After adjustment for total cholesterol, blood pressure, and smoking, a number of psychological factors appeared to be independently associated with an increased risk of MI. For the present study the same group of patients was assessed for consumption of different types of alcoholic beverages, coffee, sugar, high-fat diet, and vegetables.
In the univariate analysis patients appeared to have consumed more red wine (odds ratio [OR] 0.2, P = 0.03) and controls more spirits (OR 4.0, P = 0.005). After adjustment for total cholesterol, blood pressure, and smoking as well as the independent psycholog ical factors, red wine lost its significance (OR 0.4, P = 0.17) whereas the OR for spirits even rose (OR 6.0, P = 0.01).
The beneficial effect of wine may be an expression of a relatively low level of life stress. Alcohol itself is not protective but rather a strong risk factor of MI.
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