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Alcohol and cardiovascular disease

BMJ 2017; 356 doi: (Published 22 March 2017) Cite this as: BMJ 2017;356:j1340
  1. Kenneth Mukamal, associate professor of medicine1,
  2. Mariana Lazo, assistant professor medicine and epidemiology2
  1. 1Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
  2. 2Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins School of Public Health and School of Medicine, Baltimore, MD 21202, USA
  1. Correspondence to: kmukamal{at}

Big data puts the link between moderate drinking and lower risk under the microscope

Over four decades ago, Klatsky and his colleagues published perhaps the first carefully conducted epidemiological investigation of alcohol consumption and risk of myocardial infarction,1 a case-control study nested within the health records of the Kaiser Foundation Health Plan in California. Taking advantage of some 120 000 health plan members who completed a standardized set of over 500 individual questions, the authors identified 464 members who sustained an incident myocardial infarction at local Kaiser hospitals. They compared the alcohol consumption reported on a previous questionnaire among these members with that of two sets of controls drawn from the same source population. Among non-smokers, the odds of myocardial infarction were about twice as high among non-drinkers as among drinkers, raising the possibility that alcohol consumption could lower risk of coronary heart disease.1

In subsequent analyses of members of the Kaiser-Permanente health maintenance organization, Klatsky and colleagues went on to show that alcohol consumption has diverse associations with various forms of cardiovascular disease and its risk factors, including a roughly …

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