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Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits?

BMJ 1996; 312 doi: http://dx.doi.org/10.1136/bmj.312.7033.731 (Published 23 March 1996) Cite this as: BMJ 1996;312:731
  1. Eric B Rimm, assistant professor of epidemiology and nutritiona,
  2. Arthur Klatsky, senior consultant in cardiologyb,
  3. Diederick Grobbee, professor of epidemiologyc,
  4. Meir J Stampfer, professor of epidemiology and nutritiona
  1. a Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA
  2. b Kaiser Permanente Medical Center and the Division of Research Group, Oakland CA, USA
  3. c Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, Netherlands
  1. Correspondence to: Dr Rimm.
  • Accepted 18 December 1995

Abstract

Objectives: To review the effect of specific types of alcoholic drink on coronary risk.

Design: Systematic review of ecological, case-control, and cohort studies in which specific associations were available for consumption of beer, wine, and spirits and risk of coronary heart disease.

Subjects: 12 ecological, three case-control, and 10 separate prospective cohort studies.

Main outcome measures: Alcohol consumption and relative risk of morbidity and mortality from coronary heart disease.

Results: Most ecological studies suggested that wine was more effective in reducing risk of mortality from heart disease than beer or spirits. Taken together, the three case-control studies did not suggest that one type of drink was more cardioprotective than the others. Of the 10 prospective cohort studies, four found a significant inverse association between risk of heart disease and moderate wine drinking, four found such an association for beer, and four for spirits.

Conclusions: Results from observational studies, where alcohol consumption can be linked directly to an individual's risk of coronary heart disease, provide strong evidence that all alcoholic drinks are linked with lower risk. Thus, a substantial portion of the benefit is from alcohol rather than other components of each type of drink.

Key messages

  • Key messages

  • We examined the relation between specific alcoholic drinks and reduction of risk of coronary heart disease by summarising published reports from ecological, case-control, and cohort studies

  • Most ecological studies suggested that wine was more effective in reducing risk of mortality than beer or spirits, whereas the three case-control studies together did not suggest that one type of drink was more cardioprotective than others

  • Of the 10 prospective cohort studies, four found a significant inverse association between risk of heart disease and moderate wine drinking, four found the association for beer, and four found it for spirits.

  • The evidence suggests that all alcoholic drinks are linked with lower risk, so that much of the benefit is from alcohol rather than other components of each type of drink

Footnotes

  • Funding This report was funded by the International Life Sciences Institute (ILSI Europe Alcohol Task Force).

  • Conflict of interest None.

  • Accepted 18 December 1995
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