Heavy drinking may increase risk of cardiovascular disease

Adults who drank large amounts of alcohol over an extended time period had stiffer arteries and an increased risk of cardiovascular disease, according to a prospective cohort study in the United Kingdom. Men were particularly at risk of heart disease if they drank heavily for a long time.

Lead researcher Darragh O’Neill, PhD, of University College London, and colleagues published their results online Feb. 20 in the Journal of the American Heart Association.

The researchers mentioned that arterial stiffness is an indicator of cardiovascular health that is assessed using pulse wave velocity (PWV) and may be directly affected by alcohol consumption. They noted that previous research suggested that arterial stiffness could be used as a surrogate endpoint for cardiovascular disease studies.

For this analysis, the researchers evaluated the Whitehall II study, which recruited more than 10,000 civil servants from the U.K. between 1985 and 1988. The researchers were especially interested in measuring carotid-femoral PWV. They noted that higher PWV values indicated increased arterial stiffness.

The adults underwent clinical assessments every four to five years and self-reported their alcohol consumption. The researchers defined moderate alcohol consumption as weekly ethanol volumes of up to 112 grams (3.9 ounces).

A total of 3,869 participants completed the follow-up testing during 2012 and 2013. Of the participants, 73.7 percent were males, while 94.3 percent of males and 88.5 percent of females were white. Most of the participants did not smoke cigarettes, while 68 percent of males and 74.1 percent of females did not meet the World Health Organization’s recommended weekly exercise levels.

The researchers found that 17.7 percent of men and 4.1 percent of women were stable heavy drinkers, which they defined as drinking more than 112 grams of ethanol at each follow-up period. They also mentioned that 28.6 percent of men and 19.0 percent of women were unstable heavy drinkers, which they defined as drinking more than 112 grams of ethanol at more than half but not all of the first nine follow-up periods.

At baseline, the mean PWV was 8.5 m/s for males and 8.2 m/s for females. At the end of the follow-up period, the mean PWV was 9.1 m/s for males and 8.7 m/s for females. Both of the increases were statistically significant.

A model that adjusted for age and assessment interval found that consistently heavy drinkers had significantly higher baseline PWV values compared with a stable moderate drinking group.

After adjusting for more demographic, lifestyle and clinical factors, the PWV of male stable heavy drinkers remained significantly higher at baseline, although the associations for the stable heavy and unstable moderate female consumers were not statistically significant.

The researchers mentioned the study had a few limitations, including the potential for selection bias because they only analyzed adults who remained in the Whitehall II study for more than two decades. They also noted that they could not draw inferences on alcohol intake before the study began in the late 1980s.

“The study has shown that a consistently moderate drinking pattern is associated with lower arterial stiffness than is heavier drinking, particularly so among males,” the researchers wrote. “Discontinuation of drinking has also been shown to be associated in males with experiencing accelerated stiffness over time, and potential reasons for this and the absence of an effect among females have been offered. On the whole, the findings are compatible with the notion that consistently moderate alcohol intake is associated with lower cardiovascular risk, but suggest that the strength and form of this association may somewhat vary by sex. This work has, in particular, illustrated the new insights that can be obtained when the stability of intake levels is taken into account.”