pmc logo image
Logo of amjphAmerican Journal of Public Health Web SiteAmerican Public Health Association Web SiteSubmissionsSubscriptionsAbout Us

Formats:

Am J Public Health. 1999 May; 89(5): 685–690.
PMCID: PMC1508729
Type of alcoholic drink and risk of major coronary heart disease events and all-cause mortality.
S G Wannamethee and A G Shaper
Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London, England. goya@rfhsm.ac.uk
Abstract
OBJECTIVES: This study examined the effects of beer, spirits, and wine drinking on coronary heart disease (CHD) events (fatal and nonfatal) and all-cause mortality. METHODS: Men aged 40 to 59 years (n = 7735) were drawn at random from one general practice in each of 24 British towns and followed up for an average of 16.8 years. RESULTS: Regular drinkers showed a significantly lower relative risk of CHD, but no all-cause mortality, than occasional drinkers, even after adjustment for potential confounders. The benefit for CHD of regular drinking was seen within both beer drinkers and spirit drinkers but not among men who reported wine drinking. However, all men who reported wine drinking (both occasional and regular) showed significantly lower age-adjusted risks of CHD and all-cause mortality than men drinking beer or spirits; beer and spirit drinkers showed similar risks. CONCLUSIONS: The findings suggest that regular intake of all alcoholic drinks is associated with a lower risk of CHD, but not all-cause mortality, than occasional drinking. A large part, but not all, of the greater benefit seen in wine drinkers relative to other drinkers can be attributed to advantageous lifestyle characteristics (e.g., low rates of smoking and obesity).
Full text
Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.7M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
  • Beaglehole R, Jackson R. Alcohol, cardiovascular diseases and all causes of death: a review of the epidemiological evidence. Drug Alcohol Rev. 1992;11(3):275–289. [PubMed]
  • Marmot M, Brunner E. Alcohol and cardiovascular disease: the status of the U shaped curve. BMJ. 1991 Sep 7;303(6802):565–568. [PMC free article] [PubMed]
  • Maclure M. Demonstration of deductive meta-analysis: ethanol intake and risk of myocardial infarction. Epidemiol Rev. 1993;15(2):328–351. [PubMed]
  • Shaper AG, Wannamethee G, Walker M. Alcohol and coronary heart disease: a perspective from the British Regional Heart Study. Int J Epidemiol. 1994 Jun;23(3):482–494. [PubMed]
  • Renaud S, de Lorgeril M. Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet. 1992 Jun 20;339(8808):1523–1526. [PubMed]
  • Frankel EN, Kanner J, German JB, Parks E, Kinsella JE. Inhibition of oxidation of human low-density lipoprotein by phenolic substances in red wine. Lancet. 1993 Feb 20;341(8843):454–457. [PubMed]
  • Maxwell S, Cruickshank A, Thorpe G. Red wine and antioxidant activity in serum. Lancet. 1994 Jul 16;344(8916):193–194. [PubMed]
  • Demrow HS, Slane PR, Folts JD. Administration of wine and grape juice inhibits in vivo platelet activity and thrombosis in stenosed canine coronary arteries. Circulation. 1995 Feb 15;91(4):1182–1188. [PubMed]
  • Rimm EB, Klatsky A, Grobbee D, Stampfer MJ. Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits. BMJ. 1996 Mar 23;312(7033):731–736. [PMC free article] [PubMed]
  • Yano K, Rhoads GG, Kagan A. Coffee, alcohol and risk of coronary heart disease among Japanese men living in Hawaii. N Engl J Med. 1977 Aug 25;297(8):405–409. [PubMed]
  • Hennekens CH, Willett W, Rosner B, Cole DS, Mayrent SL. Effects of beer, wine, and liquor in coronary deaths. JAMA. 1979 Nov 2;242(18):1973–1974. [PubMed]
  • Friedman LA, Kimball AW. Coronary heart disease mortality and alcohol consumption in Framingham. Am J Epidemiol. 1986 Sep;124(3):481–489. [PubMed]
  • Klatsky AL, Armstrong MA, Friedman GD. Relations of alcoholic beverage use to subsequent coronary artery disease hospitalization. Am J Cardiol. 1986 Oct 1;58(9):710–714. [PubMed]
  • Klatsky AL, Armstrong MA. Alcoholic beverage choice and risk of coronary artery disease mortality: do red wine drinkers fare best? Am J Cardiol. 1993 Feb 15;71(5):467–469. [PubMed]
  • Grønbaek M, Deis A, Sørensen TI, Becker U, Schnohr P, Jensen G. Mortality associated with moderate intakes of wine, beer, or spirits. BMJ. 1995 May 6;310(6988):1165–1169. [PMC free article] [PubMed]
  • Klatsky AL, Armstrong MA, Friedman GD. Red wine, white wine, liquor, beer, and risk for coronary artery disease hospitalization. Am J Cardiol. 1997 Aug 15;80(4):416–420. [PubMed]
  • Shaper AG, Pocock SJ, Walker M, Cohen NM, Wale CJ, Thomson AG. British Regional Heart Study: cardiovascular risk factors in middle-aged men in 24 towns. Br Med J (Clin Res Ed) 1981 Jul 18;283(6285):179–186. [PMC free article] [PubMed]
  • Thelle DS, Shaper AG, Whitehead TP, Bullock DG, Ashby D, Patel I. Blood lipids in middle-aged British men. Br Heart J. 1983 Mar;49(3):205–213. [PMC free article] [PubMed]
  • Shaper AG, Wannamethee G, Walker M. Alcohol and mortality in British men: explaining the U-shaped curve. Lancet. 1988 Dec 3;2(8623):1267–1273. [PubMed]
  • Shaper AG, Pocock SJ, Ashby D, Walker M, Whitehead TP. Biochemical and haematological response to alcohol intake. Ann Clin Biochem. 1985 Jan;22 (:50–61. [PubMed]
  • Shaper AG, Wannamethee G, Weatherall R. Physical activity and ischaemic heart disease in middle-aged British men. Br Heart J. 1991 Nov;66(5):384–394. [PMC free article] [PubMed]
  • Cook DG, Shaper AG, MacFarlane PW. Using the WHO (Rose) angina questionnaire in cardiovascular epidemiology. Int J Epidemiol. 1989 Sep;18(3):607–613. [PubMed]
  • Walker M, Shaper AG. Follow-up of subjects in prospective studies based in general practice. J R Coll Gen Pract. 1984 Jul;34(264):365–370. [PMC free article] [PubMed]
  • Shaper AG, Pocock SJ, Walker M, Phillips AN, Whitehead TP, Macfarlane PW. Risk factors for ischaemic heart disease: the prospective phase of the British Regional Heart Study. J Epidemiol Community Health. 1985 Sep;39(3):197–209. [PMC free article] [PubMed]
  • Wannamethee G, Shaper AG. Men who do not drink: a report from the British Regional Heart Study. Int J Epidemiol. 1988 Jun;17(2):307–316. [PubMed]
  • Wannamethee SG, Shaper AG. Lifelong teetotallers, ex-drinkers and drinkers: mortality and the incidence of major coronary heart disease events in middle-aged British men. Int J Epidemiol. 1997 Jun;26(3):523–531. [PubMed]
  • Pocock SJ, Shaper AG, Cook DG, Packham RF, Lacey RF, Powell P, Russell PF. British Regional Heart Study: geographic variations in cardiovascular mortality, and the role of water quality. Br Med J. 1980 May 24;280(6226):1243–1249. [PMC free article] [PubMed]
  • Rimm EB, Giovannucci EL, Willett WC, Colditz GA, Ascherio A, Rosner B, Stampfer MJ. Prospective study of alcohol consumption and risk of coronary disease in men. Lancet. 1991 Aug 24;338(8765):464–468. [PubMed]
  • Criqui MH, Cowan LD, Tyroler HA, Bangdiwala S, Heiss G, Wallace RB, Cohn R. Lipoproteins as mediators for the effects of alcohol consumption and cigarette smoking on cardiovascular mortality: results form the Lipid Research Clinics Follow-up Study. Am J Epidemiol. 1987 Oct;126(4):629–637. [PubMed]
  • Suh I, Shaten BJ, Cutler JA, Kuller LH. Alcohol use and mortality from coronary heart disease: the role of high-density lipoprotein cholesterol. The Multiple Risk Factor Intervention Trial Research Group. Ann Intern Med. 1992 Jun 1;116(11):881–887. [PubMed]
  • Gaziano JM, Buring JE, Breslow JL, Goldhaber SZ, Rosner B, VanDenburgh M, Willett W, Hennekens CH. Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med. 1993 Dec 16;329(25):1829–1834. [PubMed]
  • Pikaar NA, Wedel M, van der Beek EJ, van Dokkum W, Kempen HJ, Kluft C, Ockhuizen T, Hermus RJ. Effects of moderate alcohol consumption on platelet aggregation, fibrinolysis, and blood lipids. Metabolism. 1987 Jun;36(6):538–543. [PubMed]
  • Hendriks HF, Veenstra J, Velthuis-te Wierik EJ, Schaafsma G, Kluft C. Effect of moderate dose of alcohol with evening meal on fibrinolytic factors. BMJ. 1994 Apr 16;308(6935):1003–1006. [PMC free article] [PubMed]