European Journal of Epidemiology

, Volume 26, Issue 11, pp 833–850 | Cite as

Wine, beer or spirit drinking in relation to fatal and non-fatal cardiovascular events: a meta-analysis

  • Simona Costanzo
  • Augusto Di Castelnuovo
  • Maria Benedetta Donati
  • Licia Iacoviello
  • Giovanni de Gaetano
REVIEW

Abstract

In previous studies evaluating whether different alcoholic beverages would protect against cardiovascular disease, a J-shaped relationship for increasing wine consumption and vascular risk was found; however a similar association for beer or spirits could not be established. An updated meta-analysis on the relationship between wine, beer or spirit consumption and vascular events was performed. Articles were retrieved through March 2011 by PubMed and EMBASE search and a weighed least-squares regression analysis pooled data derived from studies that gave quantitative estimation of the vascular risk associated with the alcoholic beverages. From 16 studies, evidence confirms a J-shaped relationship between wine intake and vascular risk. A significant maximal protection—average 31% (95% confidence interval (CI): 19–42%) was observed at 21 g/day of alcohol. Similarly, from 13 studies a J-shaped relationship was apparent for beer (maximal protection: 42% (95% CI: 19–58%) at 43 g/day of alcohol). From 12 studies reporting separate data on wine or beer consumption, two closely overlapping dose–response curves were obtained (maximal protection of 33% at 25 g/day of alcohol). This meta-analysis confirms the J-shaped association between wine consumption and vascular risk and provides, for the first time, evidence for a similar relationship between beer and vascular risk. In the meta-analysis of 10 studies on spirit consumption and vascular risk, no J-shaped relationship could be found.

Keywords

Meta-analysis Alcohol Cardiovascular disease Mortality 

References

  1. 1.
    Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen K. Alcohol and coronary heart disease: a meta-analysis. Addiction. 2000;95(10):1505–23.PubMedCrossRefGoogle Scholar
  2. 2.
    Di Castelnuovo A, Rotondo S, Iacoviello L, Donati MB, de Gaetano G. Meta-analysis of wine and beer consumption in relation to vascular risk. Circulation. 2002;105(24):2836–44.PubMedCrossRefGoogle Scholar
  3. 3.
    Corrao G, Bagnardi V, Zambon A, La Vecchia C. A meta-analysis of alcohol consumption and the risk of 15 diseases. Prev Med. 2004;38(5):613–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Di Castelnuovo A, Costanzo S, Bagnardi V, Donati MB, Iacoviello L, de Gaetano G. Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies. Arch Intern Med. 2006;166(22):2437–45.PubMedCrossRefGoogle Scholar
  5. 5.
    Costanzo S, Di Castelnuovo A, Donati MB, Iacoviello L, de Gaetano G. Alcohol consumption and mortality in patients with cardiovascular disease: a meta-analysis. J Am Coll Cardiol. 2010;55(13):1339–47.PubMedCrossRefGoogle Scholar
  6. 6.
    Reynolds K, Lewis B, Nolen JD, Kinney GL, Sathya B, HeJ. Alcohol consumption and risk of stroke: a meta-analysis. JAMA. 2003;289(5):579–88.Google Scholar
  7. 7.
    Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ. 2011;342:d671.Google Scholar
  8. 8.
    Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ. 1999;319(7224):1523–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Di Castelnuovo A, Costanzo S, di Giuseppe R, de Gaetano G, Iacoviello L. Alcohol consumption and cardiovascular risk: mechanisms of action and epidemiologic perspectives. Future Cardiol. 2009;5(5):467–77.PubMedCrossRefGoogle Scholar
  10. 10.
    Gresele P, Cerletti C, Guglielmini G, Pignatelli P, de Gaetano G, Violi F. Effects of resveratrol and other wine polyphenols on vascular function: an update. J Nutr Biochem. 2011;22(3):201–11.PubMedCrossRefGoogle Scholar
  11. 11.
    Piazzon A, Forte M, Nardini M. Characterization of phenolics content and antioxidant activity of different beer types. J Agric Food Chem. 2010;58(19):10677–83.PubMedCrossRefGoogle Scholar
  12. 12.
    Martinez N, Urpi-Sarda M, Martinez-Gonzalez MA, Andres-Lacueva C, Mitjavila MT. Dealcoholised beers reduce atherosclerosis and expression of adhesion molecules in apoE-deficient mice. Br J Nutr. 2011;105(5):721–30.PubMedCrossRefGoogle Scholar
  13. 13.
    Bagnardi V, Zambon A, Quatto P, Corrao G. Flexible meta-regression functions for modeling aggregate dose-response data, with an application to alcohol and mortality. Am J Epidemiol. 2004;159(11):1077–86.PubMedCrossRefGoogle Scholar
  14. 14.
    Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA. 2000;283(15):2008–12.Google Scholar
  15. 15.
    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;297(8):405–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Stampfer MJ, Colditz GA, Willett WC, Speizer FE, Hennekens CH. A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N Engl J Med. 1988;319(5):267–73.Google Scholar
  17. 17.
    Bianchi C, Negri E, LaVecchia C, Franceschi S. Alcohol consumption and the risk of acute myocardial infarction in women. J Epidemiol Community Health. 1993;47(4):308–11.PubMedCrossRefGoogle Scholar
  18. 18.
    Tavani A, La Vecchia C, Negri A, D’Avanzo B, Franzoni M, Tognoni G. Alcohol intake and risk of myocardial infarction in Italian men. J Epidemiol Biostat. 1996;1(1):31–9.Google Scholar
  19. 19.
    Renaud SC, Guéguen R, SiestG, Salamon R. Wine, beer, and mortality in middle-aged men from eastern France. Arch Intern Med. 1999;159(16):1865–70.Google Scholar
  20. 20.
    Bobak M, Skodova Z, Marmot M. Effect of beer drinking on risk of myocardial infarction: population based case-control study. BMJ. 2000;320(7246):1378–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Grønbaek M, Becker U, Johansen D, et al. Type of alcohol consumed and mortality from all causes, coronary heart disease, and cancer. Ann Intern Med. 2000;133(6):411–9.PubMedGoogle Scholar
  22. 22.
    Theobald H, Bygren LO, Carstensen J, Engfeldt P. A moderate intake of wine is associated with reduced total mortality and reduced mortality from cardiovascular disease. J Stud Alcohol. 2000;61(5):652–6.PubMedGoogle Scholar
  23. 23.
    Malarcher AM, Giles WH, Croft JB, et al. Alcohol intake, type of beverage, and the risk of cerebral infarction in young women. Stroke. 2001;32(1):77–83.PubMedCrossRefGoogle Scholar
  24. 24.
    Tavani A, Bertuzzi M, Negri E, Sorbara L, La Vecchia C. Alcohol, smoking, coffee and risk of non-fatal acute myocardial infarction in Italy. Eur J Epidemiol. 2001;17(12):1131–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Mukamal KJ, Conigrave KM, Mittleman MA, et al. Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. N Engl J Med. 2003;348(2):109–18.PubMedCrossRefGoogle Scholar
  26. 26.
    Nielsen NR, Schnohr P, Jensen G, Grønbaek M. Is the relationship between type of alcohol and mortality influenced by socio-economic status? J Intern Med. 2004;255(2):280–8.PubMedCrossRefGoogle Scholar
  27. 27.
    Mukamal KJ, Chung H, Jenny NS, et al. Alcohol consumption and risk of coronary heart disease in older adults: the Cardiovascular Health Study. J Am Geriatr Soc. 2006;54(1):30–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Harriss LR, English DR, Hopper JL, et al. Alcohol consumption and cardiovascular mortality accounting for possible misclassification of intake: 11-year follow-up of the Melbourne Collaborative Cohort Study. Addiction. 2007;102(10):1574–85.Google Scholar
  29. 29.
    Schröder H, Masabeu A, Marti MJ, et al. Myocardial infarction and alcohol consumption: a population-based case-control study. Nutr Metab Cardiovasc Dis. 2007;17(8):609–15.Google Scholar
  30. 30.
    Lu M, Ye W, Adami HO, Weiderpass E. Stroke incidence in women under 60 years of age related to alcohol intake and smoking habit. Cerebrovasc Dis. 2008;25(6):517–25.PubMedCrossRefGoogle Scholar
  31. 31.
    Suadicani P, Hein HO, Gyntelberg F. Wine intake, ABO phenotype, and risk of ischemic heart disease and all-cause mortality: the Copenhagen Male Study—a 16-year follow-up. Alcohol. 2008;42(7):575–82.PubMedCrossRefGoogle Scholar
  32. 32.
    Streppel MT, Ocké MC, Boshuizen HC, Kok FJ, Kromhout D. Long-term wine consumption is related to cardiovascular mortality and life expectancy independently of moderate alcohol intake: the Zutphen study. J Epidemiol Community Health. 2009;63(7):534–40.Google Scholar
  33. 33.
    Greenland S. Dose-response and trend analysis in epidemiology: alternative to categorical analysis. Epidemiology. 1995;6(4):356–65.PubMedCrossRefGoogle Scholar
  34. 34.
    Royston P, Altman DG. Regression using fractional polynomials of continuous covariates: parsimonious parametric modelling. Appl Stat. 1994;43:429–67.CrossRefGoogle Scholar
  35. 35.
    Greenland S, Longnecker MP. Methods for trend estimation from summarized dose-response data, with application to meta-analysis. Am J Epidemiol. 1992;135(11):1301–9.Google Scholar
  36. 36.
    Ludbrook J. Multiple comparison procedures updated. Clin Exp Pharmacol Physiol. 1998;25(12):1032–7.PubMedCrossRefGoogle Scholar
  37. 37.
    Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.PubMedCrossRefGoogle Scholar
  38. 38.
    Wells G, Shea B, O’Connell D. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Ottawa Health Research Institute. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
  39. 39.
    Tramacere I, Scotti L, Jenab M, Bagnardi V, Bellocco R, Rota M, Corrao G, Bravi F, Boffetta P, La Vecchia C. Alcohol drinking and pancreatic cancer risk: a meta-analysis of the dose-risk relation. Int J Cancer. 2010;126(6):1474–86.Google Scholar
  40. 40.
    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;312(7033):731–6.PubMedCrossRefGoogle Scholar
  41. 41.
    Costanzo S, Di Castelnuovo A, Donati MB, Iacoviello L, de Gaetano G. Cardiovascular and overall mortality risk in relation to alcohol consumption in patients with cardiovascular disease. Circulation. 2010;121(17):1951–9.PubMedCrossRefGoogle Scholar
  42. 42.
    Rehm J, Sempos CT, Trevisan M. Alcohol and cardiovascular disease -more than one paradox to consider. Average volume of alcohol consumption, patterns of drinking and risk of coronary heart disease- a review. J Cardiovasc Risk. 2003;10(1):15–20.PubMedCrossRefGoogle Scholar
  43. 43.
    Trevisan M, Schisterman E, Mennotti A, Farchi G, Conti S, Risk Factor and Life Expectancy Research Group. Drinking pattern and mortality: the Italian risk factor and life expectancy pooling project. Ann Epidemiol. 2001;11(5):312–9.Google Scholar
  44. 44.
    Bagnardi V, Zatonski W, Scotti L, La Vecchia C, Corrao G. Does drinking pattern modify the effect of alcohol on the risk of coronary heart disease? Evidence from a meta-analysis. J Epidemiol Community Health. 2008;62(7):615–9.PubMedCrossRefGoogle Scholar
  45. 45.
    Della Valle E, Stranges S, Trevisan M, et al. Drinking habits and health in Northern Italian and American men. Nutr Metab Cardiovasc Dis. 2009;19(2):115–22.PubMedCrossRefGoogle Scholar
  46. 46.
    Bloomfield K, Stockwell T, Gmel G, Rehn N. International comparison of alcohol consumption. Alcohol Res Health. 2003;27(1):95–109.PubMedGoogle Scholar
  47. 47.
    Rimm EB, Stampfer MJ. Wine, beer, and spirits: are they really horses of a different color? Circulation. 2002;105(24):2806–7.PubMedCrossRefGoogle Scholar
  48. 48.
    Di Castelnuovo A, Costanzo S, Donati MB, Iacoviello L, de Gaetano G. Prevention of cardiovascular risk by moderate alcohol consumption: epidemiologic evidence and plausible mechanisms. Intern Emerg Med. 2010;5(4):291–7.PubMedCrossRefGoogle Scholar
  49. 49.
    Estruch R, Sacanella E, Badia E, et al. Different effects of red wine and gin consumption on inflammatory biomarkers of atherosclerosis: a prospective randomized crossover trial. Effects of wine on inflammatory markers. Atherosclerosis. 2004;175(1):117–23.Google Scholar
  50. 50.
    Concato J, Shah N, Horwitz RI. Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med. 2000;342(25):1887–92.PubMedCrossRefGoogle Scholar
  51. 51.
    Fillmore KM, Stockwell T, Chikritzhs T, Bostrom A, Kerr W. Moderate alcohol use and reduced mortality risk: systematic error in prospective studies and new hypotheses. Ann Epidemiol. 2007;17(5 Suppl):S16–23.PubMedCrossRefGoogle Scholar
  52. 52.
    Maclure M. Demonstration of deductive meta-analysis: ethanol intake and risk of myocardial infarction. Epidemiol Rev. 1993;15(2):328–51.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Simona Costanzo
    • 1
  • Augusto Di Castelnuovo
    • 1
  • Maria Benedetta Donati
    • 1
  • Licia Iacoviello
    • 1
  • Giovanni de Gaetano
    • 1
  1. 1.Laboratory of Genetic and Environmental EpidemiologyResearch Laboratories, Fondazione di Ricerca e Cura “Giovanni Paolo II”CampobassoItaly

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