According to a study, researchers have shown that alcohol intake trajectories differ in their associations with biomarkers of cardiovascular functioning, but it remains unclear if they also differ in their relationship to actual coronary heart disease (CHD) incidence.  The study was published in the open access journal BMC Medicine that examined data on 35,132 individuals.

Researchers found that compared to individuals who consistently followed UK sensible drinking guidelines over a period of ten years, those who inconsistently drank in moderation, those who had stopped drinking (former drinkers) and those who reported no drinking had a higher risk of coronary heart disease (CHD), although the effect observed in non-drinkers may be confined to women.

Risk Of CHD

This study uses long-term data to distinguish between persistent non-drinkers and former drinkers, allowing us to test the established theory that only the latter have an elevated risk of CHD.

They did not find this to be the case, but we did observe a sex-related difference. Amongst consistent non-drinkers, women showed a higher risk of developing CHD compared to consistently moderate drinkers, but their male counterparts did not.

Overall, 1,718 (4.9%) out of the 35,132 individuals included in the six cohorts that were examined in this study developed CHD during the study period, of which 325 (0.9%) were fatal CHD events. Observed CHD incidence was highest for former drinkers, 6.1% of whom experienced a CHD event of which 1.2% were fatal, and lowest for consistently heavy drinkers, 3.8% of whom experienced a CHD event of which 0.6% were fatal.

CHD Risk In Heavy Drinkers

The authors caution that there is considerable doubt around the estimates of CHD risk in heavy drinkers due to an under-representation of heavy drinkers in the study sample, especially among women.

The findings suggest that instability in drinking behavior over time is associated with CHD risk. This may be because unstable drinking patterns reflect wider lifestyle changes across the course of people's lives, including periods of ill-health or life stress.

Lifestyle Changes

Lifestyle changes may also account for variations in risk the authors observed when they compared different age groups. When we split the sample by age, we found that the elevated risk of incident CHD amongst inconsistently moderate drinkers was observed in participants aged over 55, but not those aged below. 

To examine associations between CHD and drinking behavior over time, the authors analyzed prospectively collected, longitudinal data on self-reported weekly alcohol consumption from six studies five from the UK.

Long-Term Drinkers

The authors note that a lack of information on alcohol intake before the beginning of the 10-year assessment period could mean that the long-term abstainers identified in this study include some former drinkers.

Sick heavy drinkers may also not have been captured in the study sample due to possible dropout from the investigation at an earlier stage. The observational nature of the individual studies included in this analysis does not allow for conclusions to be drawn about cause and effect.