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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:2252.)
© 2003 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Alcohol Consumption and Carotid Atherosclerosis in Older Adults

The Cardiovascular Health Study

Kenneth J. Mukamal; Richard A. Kronmal; Murray A. Mittleman; Daniel H. O’Leary; Joseph F. Polak; Mary Cushman; David S. Siscovick

From the Divisions of General Medicine and Primary Care (K.J.M.) and Cardiology (M.A.M.), Beth Israel Deaconess Medical Center, Boston, Mass; Departments of Biostatistics (R.A.K.), Epidemiology (D.S.S.), and Medicine (D.S.S.), University of Washington, Seattle, Wash; Department of Epidemiology (M.A.M.), Harvard School of Public Health, Boston, Mass; Department of Radiology (D.H.O.), Tufts University School of Medicine, Boston, Mass; Department of Radiology (J.F.P.), Brigham and Women’s Hospital, Boston, Mass; and Departments of Medicine (M.C.) and Pathology (M.C.), University of Vermont, Burlington, Vt.

Correspondence to Kenneth J. Mukamal, MD, MPH, MA, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, RO-114, Boston, MA 02215. E-mail kmukamal{at}caregroup.harvard.edu

Objective— The association of alcohol use with atherosclerosis is inconsistent in previous studies.

Methods and Results— For the Cardiovascular Health Study, 5888 adults aged 65 years and older underwent a standardized interview and examination. They reported beer, wine, and liquor use individually and underwent B-mode ultrasonography to determine internal and common carotid intima-media thickness (IMT). We compared composite carotid IMT values cross-sectionally using linear regression to adjust for demographic and clinical characteristics. Among 4247 participants free of cardiovascular disease, consumers of 1 to 6 drinks per week had 0.07±0.04-mm lower composite IMT and consumers of 14 or more drinks per week had 0.07±0.05-mm higher IMT than abstainers (P quadratic trend=0.02). We found similar relationships using internal and common carotid thickness measures and among men and women. The higher IMT associated with heavier alcohol use was particularly strong among 1592 participants with confirmed cardiovascular disease (0.24±0.09 mm greater than abstainers). Controlling for HDL cholesterol levels reduced the effect on composite IMT among consumers of 1 to 6 drinks per week by 22%.

Conclusions— Relative to older adults who abstain from alcohol, consumption of 1 to 6 drinks per week had an inverse association with carotid atherosclerosis whereas consumption of 14 or more drinks had a positive association.

Key Words: alcohol consumption • carotid artery • atherosclerosis • intima-media thickness • epidemiology

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