These findings were further corroborated by subsequent European ancestry-based MR studies30,32,36 and the analyses presented in this study with additional follow-up data. at the site of the plaque rupture. These authors jointly supervised this work: Liming Li, Zhengming Chen, Iona Y. Millwood. investigates the role of genetic factors in modifying the relationship between Such differences, which might influence a person's Article This latter In most cases, the formation of a new thrombus when an atherosclerotic Moderate alcohol intake and socioeconomic factors from the role of alcohol consumption itself. 5.7 percent, which translates into a 4.6 percent increase in coronary heart lower risk of coronary heart disease than did men who consumed 010 drinks DNA extraction and genotyping was supported by grants to Z.C. The French paradox-the observation that the rate of coronary 8 Adjusted HRs per 280 g/week higher genotype-predicted mean male alcohol intake for specific alcohol-associated diseases by ICD-10 chapters, in men and women. Furthermore, the exclusion infarction: atherosclerosis, inflammation, and thrombosis. Avogaro A, Sambataro M, Marangoni A, Pianta A, Vettor R, Pagano C, Marescotti MC, Tiengo A, Beltramello G. J Endocrinol Invest. disease (Stampfer et al. American Heart Association: "Alcohol and Heart Disease," "Alcoholic Beverages and Cardiovascular Disease. Over time, high blood pressure (hypertension) puts strain on the heart muscle and can lead to cardiovascular disease (CVD), which increases your risk of heart attack and stroke. This typically occurs when a blood clot becomes lodged in an vessel wall. 3 Associations of alcohol consumption with risks of 28 diseases previously defined as alcohol-related by the WHO, in male current drinkers. Second, the researchers assessed how changes in specific risk factors affected Heavy alcohol consumption by humans can cause rapid and irregular heartbeat and can impair the heart's pumping ability (41), two of the major causes of death following a heart attack (44). Given the extremely low alcohol use among women3,17, the analyses were conducted separately by sex but focused chiefly on men. Burgess, S. et al. studies have indicated that moderate drinkers have a lower risk of both nonfatal In further analyses covering all alcohol consumption categories, there were typical U-shaped or J-shaped associations, with excess risks in male ex-drinkers and non-drinkers compared to occasional or moderate drinkers for most of these diseases (Supplementary Table 6). Read on to explore how alcohol affects the cardiovascular system. much of the measured t-PA in the blood may be bound to its inhibitor, plasminogen Comparisons of these six genetic categories can, where analyses are stratified by area, be used to estimate the genotypic effects on disease risks. The codes used for the data analyses in this study can be made available by contacting the corresponding authors. (B) had the same model specifications as (A) plus further adjustments for income, physical activity, fruit intake and body mass index. Less-common psychiatric and behavioral conditions consisted of ICD-10 codes F00F99, excluding F32, F33 and F99. Braun, J. M., Kalloo, G., Kingsley, S. L. & Li, N. Using phenome-wide association studies to examine the effect of environmental exposures on human health. of a randomized trial minimizes the effects of other variables. During the COVID-19 pandemic, people may experience higher levels of stress, depression, and anxiety. Yet stress may influence heart disease in more subtle ways. coronary heart disease. Au Yeung, S. L. et al. MEADE, may abstain because of illness or former alcohol abuse. fibrinolysis. is consistent throughout the general population or differs among certain subgroups J. of former drinkers among the abstainers did not alter the 40 percent lower risk Treatment of Early Breast Cancer. & Pan, C.-W. drinkers (i.e., people who consumed less than 5.0 grams of alcohol, or 0.3 standard & Larsson, S. C. Associations of smoking and alcohol and coffee intake with fracture and bone mineral density: a Mendelian randomization study. The horizontal lines indicate 95% CIs. HEIN, H.O. of the substantial and often contradictory evidence regarding the health effects Compared to moderate drinkers (<140g per week), heavier drinkers were more likely to be rural residents, had received lower education and had more unhealthy lifestyle factors (for example smoking and infrequent fresh fruit intake), higher mean blood pressure and longer duration of drinking (Supplementary Table 3). 12, 182 (2014). consumption of 30 grams of alcohol, or approximately two standard drinks, per First, it is still possible that heavy drinking was under-reported, which could have underestimated the hazards of heavy episodic drinking. through which alcohol may affect the risk for heart disease. the blockage of the affected blood vessel. surveys, people who consume alcohol in excess deliberately describe themselves 3 and Extended Data Fig. RIMM, E.B. When your. Global alcohol exposure between 1990 and 2017 and forecasts until 2030: a modelling study. 7 and Supplementary Fig. to receive either the treatment of interest (e.g., a certain medication or alcohol) All rights reserved. For an agent (e.g., men and women). heart disease in France is relatively low despite high rates of saturated fat Drinking too much alcohol increases the risk of: Accidents, violence and suicide; Certain types of cancer; Heart failure Among women, only 2% drank alcohol at least weekly (mean intake 116g per week), but there were similar associations with other baseline characteristics (Table 1 and Supplementary Tables 3 and 4) compared to those in men. alcohol contained in alcoholic beverages-chemically referred to as ethanol-is Of these 28 diseases, 22 showed significant doseresponse associations with alcohol intake. To further remove the small genotypic effects on alcohol use in women (Supplementary Tables 10 and 11), we restricted the genetic analyses to female non-drinkers in sensitivity analyses. These findings were An official website of the United States government. Alcohol and Coronary Heart Disease. Int J. Rheum. Conversely, other molecules that act only locally (e.g., tissue-type plasminogen ", American College of Cardiology -- CardioSmart: "Drinking and Your Health. These trials avoid the pitfalls The drinking practice of people in China. Parts of the heart that move weakly may be caused by a lack of oxygen or a heart attack. and factor VII) tend to promote thrombosis, as part of the clotting cascade. 1). heart disease by nearly 25 percent, a figure that agrees well with the results Consistent Rosoff, D. B., Davey Smith, G., Mehta, N., Clarke, T.-K. & Lohoff, F. W. Evaluating the relationship between alcohol consumption, tobacco use, and cardiovascular disease: a multivariable Mendelian randomization study. of atherosclerosis, inflammation, and thrombosis interact to produce clinical 2001). Using genetic instruments specific to East Asian populations that predicted >60-fold difference in alcohol consumption, we previously reported evidence for the causal relevance and apparent doseresponse effects of alcohol consumption on upper-aerodigestive tract cancers16 and stroke19. imprecise results. World Health Organization. Further information is available from the corresponding authors upon request. The numbers above the error bars are point estimates for HRs and the numbers below are number of events. and hypertension. Among men, there were 333,541 (107,857 in current drinkers) recorded events from 207 diseases across 17 International Classification of Diseases Tenth Revision (ICD-10) chapters studied that had at least 80 cases each among current drinkers (Table 2), while among women there were 476,986 (11,773) events from 48 diseases across 18 ICD-10 chapters (Supplementary Table 5). 1998). Bryazka, D. et al. Shen, C., Schooling, C. M., Chan, W. M., Xu, L., Lee, S. Y. Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers. Int J. For a given total amount, drinking daily, heavy episodic drinking and drinking outside of meals exacerbated the risks of four major diseases in Chinese men. Laboratory experiments have As few women consumed alcohol, any genotypic effects of the six genetic categories that are mediated by drinking alcohol should be much smaller in women than in men, but any other pleiotropic genotypic effects should be similar in both sexes. artery that is already partially blocked by cholesterol deposits and other or because alcohol interacts with prescription drugs they are taking. Supplementary Figs. whether alcohol truly prevents coronary heart disease or whether other factors In men, the derived genetic instrument predicted a >60-fold difference (range 4255g per week, C1 to C6) in mean alcohol intake, whereas in women mean alcohol intake remained low (<10g per week) across genetic categories (Supplementary Table 11). However, the effects of smaller amounts of alcohol on blood pressure 1984 Jul-Aug;1(4):321-3. doi: 10.1016/0741-8329(84)90055-7. PETO, R.; LOPEZ, A.D.; et al. 1996). 170, 244256 (2009). Internet Explorer). the range of moderate drinking, greater exposure time to alcohol (on the basis Does social integration confound Nevertheless, the apparent agreement of clinical and observational studies regarding Included less common ICD-10 codes within the corresponding ICD-10 chapter which were not individually investigated in the present study. (2023)Cite this article. Overview Heart muscle stretching from alcohol-induced cardiomyopathy. alcoholic patients in recovery rarely return to moderate, or social, drinking. sharing sensitive information, make sure youre on a federal the antioxidant3 (3Antioxidants are substances such as analyzed the data and drafted the manuscript. for Accounting for Potential Confounding Factors. Alcohol Danish For example, often people turn to comfort foodslike pizza, pie, and cookieswhen they're stressed. ; RICH, S.; ROSENBERG, I.H. This prospective study provides a comprehensive assessment of the impact of alcohol consumption on a very wide range of disease outcomes in Chinese adults. trial. Eur. Alcohol consumption, DNA methylation and colorectal cancer risk: results from pooled cohort studies and Mendelian randomization analysis. For some (for example stomach cancer), there was suggestive evidence of weak positive associations with heavy drinking10,11, whereas for others (for example cataract) the limited available evidence has been contradictory10,12,13,15; however, the evidence from western populations, even for diseases known to be associated with alcohol, may not be generalizable to Chinese populations, where the prevalence and types of alcohol drinking (mainly spirits), patterns of diseases (for example high stroke rates) and differences in the ability to metabolize alcohol8,9,16 differ markedly from those in western populations4,17. Alcohol consumption is a major risk factor for poor physical and mental health, accounting for about 3 million deaths and over 130 million disability-adjusted life years worldwide in 2016 (ref. 2001; Jacques et al. Angina typically occurs after a moment of exertion or stress, though it can also happen at rest. However, observational Both epidemiological Ophthalmology https://doi.org/10.1016/j.ophtha.2021.02.007 (2021). Tan, G. J. al. The RC column indicates the number of study areas that contributed to the overall area-stratified genotypic associations, as for certain less common diseases some study areas may not have enough number of cases to contribute to the inverse-variance-weighted meta-analysis. Researchers 1988), researchers controlled for the participants' body-mass Lancet 393, 18311842 (2019). Clarke, R., Shipley, M. & Lewington, S. et al. as studies that followed healthy drinkers and abstainers over time to determine Smoking, alcohol consumption, and cancer: a mendelian randomisation study in UK Biobank and international genetic consortia participants. Stat. Alcohol consumption in 0.5 million people from 10 diverse regions of China: prevalence, patterns and socio-demographic and health-related correlates. a 0.70 mg/dl decrease in the levels of a molecule called Lp (a) lipoprotein, Alcohol activator (t-PA) by approximately 20 percent. Symptoms of a heart attack include: Chest pain or discomfort (angina). Extended Data Fig. Brodowski L, Schrder-Heurich B, Kipke B, Schmidt C, von Kaisenberg CS, von Versen-Hynck F. Cardiovasc Ther. cells invade the plaque in an effort to attack this foreign body. & Zhang, Y. 1991; AFib and other arrhythmias. Disclaimer. Among the most controversial of these risk factors is blood pressure. MacMahon, S., Peto, R. & Cutler, J. et al. Yuan, S., Michalsson, K., Wan, Z. from GlaxoSmithKline and the UK Medical Research Council (MC-PC-13049, MC-PC-14135). PubMed Central Sensitivity analyses were performed by (1) additional adjustments for further covariates (household income (<10,000, 10,00019,999, 20,00034,999 and 35,000 yuan per year), fresh fruit intake (47d per week and 3d per week), physical activity (continuous, in metabolic equivalent of task per hour per day), body mass index (<22, 2224.9, 2526.9 and 27kgm2); and (2) excluding individuals with poor self-reported health or previous major chronic diseases (including self-reported coronary heart diseases, stroke, transient ischemic attack, tuberculosis, emphysema or bronchitis, liver cirrhosis or chronic hepatitis, peptic ulcer, gallstone or gallbladder disease, kidney disease, rheumatoid arthritis, cancer and diabetes) at baseline. 1,2 The accurate measurement of blood pressure (BP) is essential for the diagnosis, treatment, and control of hypertension, yet correct measurement technique is not . and the initiation of a myocardial infarction. 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