Alcohol consumption and Ischemic Heart Disease mortality in Sweden

Abstract

Most previous studies on the relationship between alcohol consumption and mortality from ischemic heart disease (IHD) have been conducted in countries with an alcohol consumption pattern different from that in Sweden (and other countries in the “Vodka Belt”), where irregular binge drinking of distilled spirits is common. Therefore, we carried out an ecological study in Sweden where cross-sectional, longitudinal, and time series analyses (1973–1986) were performed on consumption of spirits, wine, and beer in relation to age-standardized mortality in IHD for males and females.

There was a negative correlation in both cross-sectional and longitudinal analyses between wine consumption and mortality from IHD, especially strong for women, but no consistent relationship between the consumption of total ethanol, spirits and beer versus the mortality from IHD. In the time series analysis, only wine was negatively correlated with IHD mortality for women. We conclude that, on a population level, consumption of spirits and beer in a Swedish drinking pattern does not imply any protection against death from IHD. On the other hand, wine consumption in Sweden could be associated with a reduced risk of IHD death among women.

Keywords

alcohol ecological analysis ischemic heart disease mortality.

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References

Rimm E , Giovahnucci EL , Willett WC , Colditz GA , Ascherio A , Rosner B et al. Prospective study of alcohol consumption and risk of coronary disease in men . Lancet 1991; 338: 464–8.

Jackson R , Scragg R , Beaglehole R. Alcohol consumption and risk of coronary heart disease . BMJ 1991; 303: 211–16.

Shaper A , Wannamethee G , Walker M. Alcohol and mortality of British men: explaining the U-shaped curve . Lancet 1988; ii: 1267–73.

Steinberg D , Pearson T , Kuller L. Alcohol and atherosclerosis . Ann Intern Med 1991; 114: 967–76.

Langer R , Criqui MH , Reed DM. Lipoproteins and blood pressure as biological pathways for effect of moderate alcohol consumption on coronary heart disease . Circulation 1992; 85: 910–15.

Klatsky A , Armstrong MA , Friedman GD. Alcohol and mortality . Ann Intem Med 1992; 117(8): 646–54.

Frankel E , Kanner J , German JB , Parks E , Kinsella JE. Inhibition of oxidation of human low-density lipoprotein by phenolic substances in red wine . Lancet 1993; 341: 454–7.

Renaud S , Beswick AD , Fehily AM , Sharp DS , Elwood PC. Alcohol and platelet aggregation: the Caerphilly Prospective Heart Disease Study . Am J Clin Nutr 1992; 55: 1012–17.

Rosén M. Epidemiology in planning for health with special reference to regional epidemiology and the use of health registers. Thesis. Umeå University, Umeå/SPRI tryck 152. SPRI 1987.

10.

Gruchow H , Hoffman RG , Anderson AJ , Barboriak JJ. Effects of drinking patterns on the relationship between alcohol and coronary occlusion . Atherosclerosis 1982; 43: 393–404.

11.

Suhonen O , Aromaa A , Reunanen A , Knekt P. Alcohol consumption and sudden coronary death in middle-aged Finnish men . Acta Med Scand 1987; 221: 335–41.

12.

Box GEP , Jenkins GM , Reinsel GC. Time Series Analysis. Forecasting and Control. Prentice Hall, New Jersey. Third Edition, 1994.

13.

Skog O-J. Methodological problems in the analysis of temporal covariation between alcohol consumption and ischemic heart disease . Br J Addic 1983; 78: 157–72.

14.

de Fairè U , Friberg L , Lorich U , Lundman T. A validation of cause-of-death certification in 1,156 deaths . Acta Med Scand 1976; 200: 223–8.

15.

Ahlbom A , Nordlander R. Application of diagnostic criteria in the diagnosis of myocardial infarction . Scand J Soc Med 1979; 7: 67–72.

16.

Petersson B , Krantz P , Kristensson H , Trell E , Sternby NH. Alcohol-related death: A major contributor to mortality in urban middle-aged men . Lancet 1982; 2: 1088–90.

17.

Rose G. Ancel Keys Lecture . Circulation 1991; 84: 1405–9.

18.

Huhtasaari F , Asplund K , Wester PO. Cardiovascular risk factors in the northern Sweden MONICA study . Acta Med Scand 1988; 224: 99–108.

19.

Janlert U , Asplund K , Weinehall L. Unemployment and cardiovascular risk indicators. Data from the MONICA survey in northern Sweden . Scand J Soc Med 1992; 20: 14–8.

20.

Nerbrand C , Svärdsudd K , Ek J , Tibblin G. Cardiovascular mortality and morbidity in seven counties in Sweden in relation to water hardness and geological settings. The project: myocardial infarction in mid-Sweden . Eur Heart J 1992; 13: 721–7.

21.

Gyllerup S , Lanke J , Lindholm LH , Scherstën B. Smoking habits, sales of fat and anti-hypertensives fail to explain the high coronary mortality in cold regions of Sweden . Scott Med J 1991; 36: 165–8.

22.

Adman LA , Kimball AW. Coronary heart disease mortality and alcohol consumption in Framingham . Am J Epidemiol 1986; 24: 481–9.

23.

Kozarevic D , Vojvodic N , Gordon T , Kaelber CT , McGee D , Zukei WJ. Drinking habits and death. The Yugoslavia cardiovascular disease study . Int J Epidemiol 1988; 12: 145–50.

24.

Renaud S , de Lorgeril M. Wine, alcohol, platelets, and the French paradox for coronary heart disease . Lancet 1992; 339: 1523–6.

25.

St. Leger AS , Cochrane AL , Moore F. Factors associated with cardiac mortality in developed countries with particular reference to the consumption of wine . Lancet 1979; I: 1017–20.

26.

Criqui M , Ringel BL.

Does diet or alcohol explain the French paradox?

Lancet 1994; 344: 1719–23.

27.

LaPorte R , Cresanta JL , Kuller LH. The relationship of alcohol consumption to atherosclerotic heart disease . Prev med 1980; 9: 22–40.

28.

Gronbak M , Deis A , Sorensen TIA , Becker U , Schnohr P , Jensen G. Mortality associated with moderate intakes of wine, beer, or spirits . BMJ 1995; 310: 1165–9.

29.

Selvin H. Durkheim's suicide and problems of empirical research . Am J Sociol 1968; 63: 607–19.

30.

Morgenstem H. Uses of Ecologic Analysis in Epidemiologic Research . Am J Public Health 1982; 72: 1336–44.

31.

Nordoy A , Lagarde M , Renaud S. Platelets during hyperlipidaemia induced by cream and cod liver oil . Eur J Clin Invest 1984; 14: 339–45.

32.

Eliasson M , Evrin P-E , Lundblad D. Fibrinogen and fibrinolytic variables in relation to anthropometry, lipids and blood pressure. The Northern Sweden MONICA Study . J Clm Epidemiol 1994; 47: 513–24.

33.

Renaud S , McGregor L , Martin JL. Influence of alcohol on platelet functions in relation to atherosclerosis. In: Pozza G , et al, eds. Diet, diabetes and atherosclerosis. New York: Raven Press, 1984: 177–87.