BMJ  2006;332:1244-1248 (27 May), doi:10.1136/bmj.38831.503113.7C (published 3 May 2006)

Research

Prospective study of alcohol drinking patterns and coronary heart disease in women and men

Janne Tolstrup, research fellow1, Majken K Jensen, research fellow1, Anne Tjønneland, senior research fellow2, Kim Overvad, research director3, Kenneth J Mukamal, assistant professor4, Morten Grønbæk, professor1

1 Centre for Alcohol Research, National Institute of Public Health, Øster Farimagsgade 5, Dk-1399 Copenhagen, Denmark, 2 Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, 3 Department of Clinical Epidemiology, Cardiovascular Research Center, Aarhus University Hospital, Aalborg, 4 Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, USA

Correspondence to: J Tolstrup jst{at}niph.dk

Abstract

Objective To determine the association between alcohol drinking patterns and risk of coronary heart disease in women and men.

Design Population based cohort study.

Setting Denmark, 1993-2002.

Participants 28 448 women and 25 052 men aged 50-65 years, who were free of cardiovascular disease at entry to the study.

Main outcome measures Incidence of coronary heart disease occurring during a median follow-up period of 5.7 years.

Results 749 and 1283 coronary heart disease events occurred among women and men. Women who drank alcohol on at least one day a week had a lower risk of coronary heart disease than women who drank alcohol on less than one day a week. Little difference was found, however, between drinking frequency: one day a week (hazard ratio 0.64, 95% confidence interval 0.51 to 0.81), 2-4 days a week (0.63, 0.52 to 0.77), five or six days a week (0.79, 0.61 to 1.03), and seven days a week (0.65, 0.51 to 0.84). For men an inverse association was found between drinking frequency and risk of coronary heart disease across the entire range of drinking frequencies. The lowest risk was observed among men who drank daily (0.59, 0.48 to 0.71) compared with men who drank alcohol on less than one day a week.

Conclusions Among women alcohol intake may be the primary determinant of the inverse association between drinking alcohol and risk of coronary heart disease whereas among men, drinking frequency, not alcohol intake, seems more important.


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Rapid Responses:

Read all Rapid Responses

Re: Prospective study of alcohol drinking patterns and coronary heart disease in women and men
Wenbin Liang
bmj.com, 6 May 2006 [Full text]
Comparison against non-drinkers worth removing
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bmj.com, 11 May 2006 [Full text]
Re: Re: Prospective study of alcohol drinking patterns and coronary heart disease in women and men
Janne Tolstrup
bmj.com, 11 May 2006 [Full text]
Please test the difference between men and women
Thomas V Perneger
bmj.com, 26 May 2006 [Full text]
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Neeraj Bhala
bmj.com, 30 May 2006 [Full text]
“Biologically Plausible Mechanisms”
Charles R. Fred
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possibly due to uncontrolled confounding
Maximilian de Courten
bmj.com, 13 Jun 2006 [Full text]
Re: The critical dimension of ethnicity in alcohol and cardiovascular health
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bmj.com, 16 Jun 2006 [Full text]
Re: possibly due to uncontrolled confounding
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rapid reversible inflammatory mechanisms
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