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Mortality Benefit Seen in Moderate Drinking Post MI


 

COLORADO SPRINGS — Moderate alcohol consumption following a first nonfatal acute MI appeared to protect against cardiovascular and all-cause mortality in the Physicians' Health Study.

This protective effect of moderate drinking was most robust in male physicians who had a nonanterior MI, Jennifer K. Pai, Sc.D., of the Harvard School of Public Health, Boston, reported at a conference sponsored by the American Heart Association. Previous studies have shown a link between moderate alcohol intake and lower risk of coronary heart disease in healthy individuals. But there have been few data on the impact of drinking after a first MI.

Dr. Pai and colleagues used data from the Physicians' Health Study, a National Institutes of Health-sponsored prospective cohort study involving more than 20,000 male physicians begun 26 years ago. Alcohol consumption data were available on 1,879 physicians immediately before they experienced a first nonfatal acute MI sometime after 1986. The drinking data were updated every 4 years afterward through 2004, at which point there were 317 deaths.

Physicians were classified into four groups on the basis of their pattern of alcohol use: an average of 0.1–9.9 g of alcohol a day, 10.0–29.9 g/day, 30 g or more/day, and nondrinkers. An alcoholic beverage typically contains 7–12 g of alcohol.

After multivariate adjustment for demographic and cardiovascular risk factors, and information on MI severity and treatment, the relative risk of all-cause mortality in physicians who drank up to 9.9 g of alcohol/day after their MI was reduced by 34%, compared with nondrinkers. In those who averaged 10.0–29.9 g/day, the relative risk reduction was 40%. For heavier drinkers, the all-cause-mortality risk reduction was 30%. For cardiovascular mortality, the adjusted relative risk reductions were 34%, 48%, and 31%, respectively, for the lightest to heaviest drinkers versus nondrinkers.

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