Skip to main content
PMC home page
The BMJ logoLink to The BMJ
. 1996 Mar 23;312(7033):736–741. doi: 10.1136/bmj.312.7033.736

Alcohol consumption, serum low density lipoprotein cholesterol concentration, and risk of ischaemic heart disease: six year follow up in the Copenhagen male study.

H O Hein 1, P Suadicani 1, F Gyntelberg 1
PMCID: PMC2350479  PMID: 8605458

Abstract

OBJECTIVES: To investigate the interplay between use of alcohol, concentration of low density lipoprotein cholesterol, and risk of ischaemic heart disease. DESIGN: Prospective study with controlling for several relevant confounders, including concentrations of other lipid fractions. SETTING: Copenhagen male study, Denmark. SUBJECTS: 2826 men aged 53-74 years without overt ischaemic heart disease. MAIN OUTCOME MEASURE: Incidence of ischaemic heart disease during a six year follow up period. RESULTS: 172 men (6.1%) had a first ischaemic heart disease event. There was an overall inverse association between alcohol intake and risk of ischaemic heart disease. The association was highly dependent on concentration of low density lipoprotein cholesterol. In men with a high concentration (> or = 5.25 mmol/l) cumulative incidence rates of ischaemic heart disease were 16.4% for abstainers, 8.7% for those who drank 1-21 beverages a week, and 4.4% for those who drank 22 or more beverages a week. With abstainers as reference and after adjustment for confounders, corresponding relative risks (95% confidence interval) were 0.4 (0.2 to 1.0; P<0.05) and 0.2 (0.1 to 0.8; P<0.01). In men with a concentration <3.63 mmol/l use of alcohol was not associated with risk. The attributable risk (95% confidence interval) of ischaemic heart disease among men with concentrations > or = 3.63 mmol/l who abstained from drinking alcohol was 43% (10% to 64%). CONCLUSIONS: In middle aged and elderly men the inverse association between alcohol consumption and risk of ischaemic heart disease is highly dependent on the concentration of low density lipoprotein cholesterol. These results support the suggestion that use of alcohol may in part explain the French paradox.

Full text

PDF
736

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Burstein M., Scholnick H. R., Morfin R. Rapid method for the isolation of lipoproteins from human serum by precipitation with polyanions. J Lipid Res. 1970 Nov;11(6):583–595. [PubMed] [Google Scholar]
  2. Castelli W. P., Doyle J. T., Gordon T., Hames C. G., Hjortland M. C., Hulley S. B., Kagan A., Zukel W. J. Alcohol and blood lipids. The cooperative lipoprotein phenotyping study. Lancet. 1977 Jul 23;2(8030):153–155. doi: 10.1016/s0140-6736(77)90176-3. [DOI] [PubMed] [Google Scholar]
  3. Castelli W. P. Epidemiology of coronary heart disease: the Framingham study. Am J Med. 1984 Feb 27;76(2A):4–12. doi: 10.1016/0002-9343(84)90952-5. [DOI] [PubMed] [Google Scholar]
  4. Criqui M. H., Cowan L. D., Tyroler H. A., Bangdiwala S., Heiss G., Wallace R. B., 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. doi: 10.1093/oxfordjournals.aje.a114702. [DOI] [PubMed] [Google Scholar]
  5. Criqui M. H., Ringel B. L. Does diet or alcohol explain the French paradox? Lancet. 1994 Dec 24;344(8939-8940):1719–1723. doi: 10.1016/s0140-6736(94)92883-5. [DOI] [PubMed] [Google Scholar]
  6. Folsom A. R. Epidemiology of fibrinogen. Eur Heart J. 1995 Mar;16 (Suppl A):21–24. doi: 10.1093/eurheartj/16.suppl_a.21. [DOI] [PubMed] [Google Scholar]
  7. Friedewald W. T., Levy R. I., Fredrickson D. S. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972 Jun;18(6):499–502. [PubMed] [Google Scholar]
  8. Gaziano J. M., Buring J. E., Breslow J. L., Goldhaber S. Z., Rosner B., VanDenburgh M., Willett W., Hennekens C. H. 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. doi: 10.1056/NEJM199312163292501. [DOI] [PubMed] [Google Scholar]
  9. Gyntelberg F. One- and two-years incidence of myocardial infarction in copenhagen males aged 40-59. Dan Med Bull. 1975 Feb;22(2):81–84. [PubMed] [Google Scholar]
  10. Gyntelberg F. Physical fitness and coronary heart disease in male residents in Copenhagen aged 40-59. Dan Med Bull. 1973 Jan;20(1):1–4. [PubMed] [Google Scholar]
  11. Hein H. O., Sørensen H., Suadicani P., Gyntelberg F. Alcohol consumption, Lewis phenotypes, and risk of ischaemic heart disease. Lancet. 1993 Feb 13;341(8842):392–396. doi: 10.1016/0140-6736(93)92987-5. [DOI] [PubMed] [Google Scholar]
  12. Hein H. O., Sørensen H., Suadicani P., Gyntelberg F. The Lewis blood group--a new genetic marker of ischaemic heart disease. J Intern Med. 1992 Dec;232(6):481–487. doi: 10.1111/j.1365-2796.1992.tb00620.x. [DOI] [PubMed] [Google Scholar]
  13. Heinrich J., Balleisen L., Schulte H., Assmann G., van de Loo J. Fibrinogen and factor VII in the prediction of coronary risk. Results from the PROCAM study in healthy men. Arterioscler Thromb. 1994 Jan;14(1):54–59. doi: 10.1161/01.atv.14.1.54. [DOI] [PubMed] [Google Scholar]
  14. Hendriks H. F., Veenstra J., Velthuis-te Wierik E. J., Schaafsma G., Kluft C. Effect of moderate dose of alcohol with evening meal on fibrinolytic factors. BMJ. 1994 Apr 16;308(6935):1003–1006. doi: 10.1136/bmj.308.6935.1003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Kiechl S., Willeit J., Egger G., Oberhollenzer M., Aichner F. Alcohol consumption and carotid atherosclerosis: evidence of dose-dependent atherogenic and antiatherogenic effects. Results from the Bruneck Study. Stroke. 1994 Aug;25(8):1593–1598. doi: 10.1161/01.str.25.8.1593. [DOI] [PubMed] [Google Scholar]
  16. Lopes-Virella M. F., Stone P., Ellis S., Colwell J. A. Cholesterol determination in high-density lipoproteins separated by three different methods. Clin Chem. 1977 May;23(5):882–884. [PubMed] [Google Scholar]
  17. ROSE G. A., HOLLAND W. W., CROWLEY E. A. A SPHYGMOMANOMETER FOR EPIDEMIOLOGISTS. Lancet. 1964 Feb 8;1(7328):296–300. doi: 10.1016/s0140-6736(64)92408-0. [DOI] [PubMed] [Google Scholar]
  18. Renaud S., de Lorgeril M. Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet. 1992 Jun 20;339(8808):1523–1526. doi: 10.1016/0140-6736(92)91277-f. [DOI] [PubMed] [Google Scholar]
  19. Ridker P. M., Vaughan D. E., Stampfer M. J., Glynn R. J., Hennekens C. H. Association of moderate alcohol consumption and plasma concentration of endogenous tissue-type plasminogen activator. JAMA. 1994 Sep 28;272(12):929–933. doi: 10.1001/jama.1994.03520120039028. [DOI] [PubMed] [Google Scholar]
  20. Rimm E. B., Giovannucci E. L., Willett W. C., Colditz G. A., Ascherio A., Rosner B., Stampfer M. J. Prospective study of alcohol consumption and risk of coronary disease in men. Lancet. 1991 Aug 24;338(8765):464–468. doi: 10.1016/0140-6736(91)90542-w. [DOI] [PubMed] [Google Scholar]
  21. Shaper A. G. Alcohol and mortality: a review of prospective studies. Br J Addict. 1990 Jul;85(7):837–861. doi: 10.1111/j.1360-0443.1990.tb03710.x. [DOI] [PubMed] [Google Scholar]
  22. Shaper A. G., Wannamethee G., Walker M. Alcohol and mortality in British men: explaining the U-shaped curve. Lancet. 1988 Dec 3;2(8623):1267–1273. doi: 10.1016/s0140-6736(88)92890-5. [DOI] [PubMed] [Google Scholar]
  23. Stähler F., Gruber W., Stinshoff K., Röschlau P. Eine praxisgerechte enzymatische Cholesterin-Bestimmung. Med Lab (Stuttg) 1977 Feb;30(2):29–37. [PubMed] [Google Scholar]
  24. Suh I., Shaten B. J., Cutler J. A., Kuller L. H. 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. doi: 10.7326/0003-4819-116-11-881. [DOI] [PubMed] [Google Scholar]
  25. Tunstall-Pedoe H., Kuulasmaa K., Amouyel P., Arveiler D., Rajakangas A. M., Pajak A. Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation. 1994 Jul;90(1):583–612. doi: 10.1161/01.cir.90.1.583. [DOI] [PubMed] [Google Scholar]
  26. Yano K., Rhoads G. G., 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. doi: 10.1056/NEJM197708252970801. [DOI] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES