Restricted accessResearch articleFirst published online 2002-12
No Protective Effect of Alcohol Consumption on Coronary Heart Disease (CHD) in African Americans: Average Volume of Drinking over the Life Course and CHD Morbidity and Mortality in a U.S. National Cohort
The association between average volume of drinking and coronary heart disease (CHD) morbidity and mortality in African Americans compared with whites was explored, based on a representative US sample. A prospective cohort study with interview follow-up after 10 years and outcome follow-up over about 15 years was used. The sample consisted of 1,158 African Americans and 6,607 whites, all 40 years of age and older with no history of heart disease at baseline. Alcohol intake was measured with a quantity-frequency measure. Incidence of CHD was the sum of non-fatal and fatal events as determined from hospital records and death certificates. The event with the earliest date was defined as the incident event. With respect to CHD, African Americans showed markedly higher risks and significantly fewer protective effects compared with whites. Thus the cardioprotective effects of alcohol were not present in a representative sample of African Americans. On the contrary: Moderate to high average volume of alcohol was associated with increased risk of CHD in African Americans. Patterns of drinking as a potential cause for this finding are discussed.
CaetanoR.Prevalence, incidence and stability of drinking problems among whites, blacks and Hispanics: 1984–1992. Journal of Studies on Alcohol1997;58:565–572.
2.
CaetanoRClarkCL.Trends in alcohol consumption patterns among whites, blacks and Hispanics: 1984 and 1995. Journal of Studies on Alcohol1998;59:659–668.
3.
CaetanoRKaskutasLA.Changes in drinking patterns among whites, blacks and Hispanics, 1984–1992. Journal of Studies on Alcohol1995;56:558–565.
4.
CaetanoRKaskutasLA.Changes in drinking problems among whites, blacks, and Hispanics: 1984–1992. Substance Use and Misuse1996;31:1547–1571.
5.
ChadwickDJGoodeJA.Alcohol and cardiovascular diseases (Symposium on alcohol and cardiovascular diseases, held at the Novartis Foundation, London, 7–9 October 1997). Chichester, UK: Wiley, 1998.
6.
CherpitelCTarnTMidanikLAlcohol in non-fatal injury in the U.S. general population: A risk function analysis. Accident Analysis and Prevention1995;27:651–661.
7.
CohenBBBarbanoHECoxCSFeldmanJJFinucaneFFKleinmanJCMadansJH.Plan and operation of the NHANES I Epidemiologic Followup Study: 1982–84. Vital and Health Statistics 11987;22:1–142.
8.
CorraoGRubbiatiLBagnardiVZambonAPoikolainenK.Alcohol and coronary heart disease: A meta-analysis. Addiction2000;95:1505–1523.
9.
CoxCSRothwellSTMadansJHFinucaneFFFreidVMKleinmanJCBarbanoHEFeldmanJJ.Plan and operation of the NHANES I Epidemiologic Followup Study, 1987. Vital and Health Statistics 11992;27:1–190.
10.
DawsonDA.Drinking patterns and their consequences: Report from an international meeting. Temporal drinking patterns and variation in social consequences. Addiction1996;91:1623–1635.
11.
DawsonDA.Beyond black, white and Hispanic: Race, ethnic origin and drinking patterns in the United States. Journal of Substance Abuse1998;10:321–339.
12.
Department of Health and Human Services. Alcohol. In: National Household Survey on Drug Abuse: Main findings 1998 (pp. 89–106). Rockville, MD: Substance Abuse and Mental Health Services Administration, 2000.
13.
FeunekesGIJvan't VeerPvan StaverenWAKokF. Alcohol intake assessment: The sober facts. American Journal of Epidemiology1999;150:105–112.
14.
FinucaneFFFreidVMMadansJHCoxCSKleinmanJCRothwellSTBarbanoHEFeldmanJJ.Plan and operation of the NHANES I Epidemiologic Followup Study, 1986. Vital and Health Statistics 11990;25:1–154.
15.
GillumRFGrantCT.Coronary heart disease in black populations. Part II: Risk factors. American Heart Journal1982;104:852–864.
16.
GrovesRM.Survey errors and survey costs. New York: Wiley, 1989.
17.
JonesDWSemposCTThomTJHarringtonAMTaylorHAFletcherBWMehrothraBDWyattSBDavisCE.Rising levels of cardiovascular mortality in Mississippi, 1979–1995. American Journal of Medical Science2000;319:131–137.
18.
Jones-WebbRHsiaoC-YHannanPCaetanoR.Predictors of increase in alcohol-related problems among black and white adults: Results from the 1984 and 1992 national alcohol surveys. American Journal of Drug and Alcohol Abuse1997;32:281–299.
19.
KahnHASemposCT.Statistical methods in epidemiology. Monographs in epidemiology and biostatistics, volume 12. New York, Oxford: Oxford University Press, 1989.
20.
KaskutasLA.Understanding drinking during pregnancy among urban American Indians and African Americans: Health messages, risk beliefs, and how we measure consumption. Alcoholism: Clinical and Experimental Research2000;24(8):1241–1250.
21.
KaskutasLAGravesK.Alternative to standard drinks as a measure of alcohol consumption. Journal of Substance Abuse2000;12(1–2):67–78.
22.
McKeeM & BrittonA.The positive relationship between alcohol and heart disease in Eastern Europe: Potential physiological mechanisms. Journal Royal Society of Medicine1998;91:402–407.
23.
MidanikLTTamTWGreenfieldTKRisk functions for alcohol-related problems in a 1988 US national sample. Addiction1996;91:1427–1437.
24.
MillerHW.Plan and operation of the Health and Nutrition Examination Survey: United States, 1971–73. Vital and Health Statistics 11973;10a:1–46.
25.
MurphySL.Deaths: Final data for 1998. National Vital Statistics Reports, vol. 48 no. 11. Hyattsville, MD: National Center for Health Statistics, 2000.
26.
MurrayRPConnettJETyasSLBondREkumaOSilversidesCKBarnesGE.Alcohol volume, drinking pattern, and cardiovascular disease morbidity and mortality: Is there a U-shaped function?American Journal of Epidemiology2002;155(3):242–248.
27.
National Center for Health Statistics. Health, United States, 2000. With adolescent health chartbook. Hyattsville, MD, 2000.
28.
PuddeyIBRakicVDimmittSBBeilinLJ.Influence of pattern of drinking on cardiovascular disease and cardiovascular risk factors—a review. Addiction1999;94:649–663.
29.
RehmJ.Alcohol intake assessment: The sober facts. American Journal of Epidemiology2000;151:436–438.
30.
RehmJAshleyMJRoomRSingleEBondySFerrenceRGiesbrechtN.Drinking patterns and their consequences: Report from an international meeting. Addiction1996;91:1615–1621.
31.
RehmJBondySSemposCTVuongCV.Alcohol consumption and coronary heart disease morbidity and mortality. American Journal of Epidemiology1997;146:495–501.
32.
RehmJGreenfieldTKRogersJD.Average volume of alcohol consumption, patterns of drinking and all-cause mortality. Results from the U.S. National Alcohol Survey. American Journal of Epidemiology2001;153:64–71.
33.
RehmJSemposCT.Alcohol and all-cause mortality. Addiction1995;90:471–480.
34.
SemposCTFlegalKMJohnsonCLLoriaCMWotekiCEBriefelRR.Issues in the long-term evaluation of diet in longitudinal studies. Journal of Nutrition1993;123:406–412.
