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Martínez-González MÁ, Hernández Hernández A. Effect of the Mediterranean diet in cardiovascular prevention. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024; 77:574-582. [PMID: 38336153 DOI: 10.1016/j.rec.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
The Mediterranean diet is the best evidence-based model for cardiovascular prevention. In addition to 2 major randomized secondary prevention trials (Lyon Heart and CORDIOPREV) and 1 primary prevention trial (PREDIMED) that have demonstrated these benefits, there is an unprecedented body of high-quality prospective epidemiological evidence supporting these beneficial effects. The key elements of this traditional pattern are the abundant use of extra-virgin olive oil and high consumption of foods of natural plant-based origin (fruits, vegetables, nuts, and legumes) and fish, along with a reduction in processed meats, red meats, and ultraprocessed products. Moderate consumption of wine, preferably red wine, with meals is an essential element of this traditional pattern. Although removing wine consumption from the Mediterranean diet has been associated with a reduction in its preventive efficacy, doubts have recently arisen about the possible adverse effect of even low or moderate intake of any alcoholic beverages. A new large Spanish trial, UNATI, which will begin in June 2024, will randomize 10 000 drinkers aged 50 to 75 years to abstention or moderate consumption. UNATI aims to answer these doubts with the best possible evidence.
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Affiliation(s)
- Miguel Á Martínez-González
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, United States.
| | - Aitor Hernández Hernández
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Departamento de Cardiología, Clínica Universidad de Navarra, Madrid, Spain
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Peng H, Wang N, Wang M, Yang C, Guo W, Li G, Huang S, Wei D, Liu D. Comparison of Activity and Safety of DSPAα1 and Its N-Glycosylation Mutants. Life (Basel) 2023; 13:life13040985. [PMID: 37109514 PMCID: PMC10145227 DOI: 10.3390/life13040985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
DSPAα1 is a potent rude thrombolytic protein with high medicative value. DSPAα1 has two natural N-glycan sites (N153Q-S154-S155, N398Q-K399-T400) that may lead to immune responses when administered in vivo. We aimed to study the effect of its N-glycosylation sites on DSPAα1 in vitro and in vivo by mutating these N-glycosylation sites. In this experiment, four single mutants and one double mutant were predicted and expressed in Pichia pastoris. When the N398Q-K399-T400 site was mutated, the fibrinolytic activity of the mutant was reduced by 75%. When the N153Q-S154-S155 sites were inactivated as described above, the plasminogen activating activity of its mutant was reduced by 40%, and fibrin selectivity was significantly reduced by 21-fold. The introduction of N-glycosylation on N184-G185-A186T and K368N-S369-S370 also considerably reduced the activity and fibrin selectivity of DSPAα1. The pH tolerance and thermotolerance of all mutants did not change significantly. In vivo experiments also confirmed that N-glycosylation mutations can reduce the safety of DSPAα1, lead to prolonged bleeding time, non-physiological reduction of coagulation factor (α2-AP, PAI) concentration, and increase the risk of irregular bleeding. This study ultimately demonstrated the effect of N-glycosylation mutations on the activity and safety of DSPAα1.
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Affiliation(s)
- Huakang Peng
- Biotechnology Research Institute, Chinese Academy of Agricultural Sciences, Beijing 100081, China
| | - Nan Wang
- Biotechnology Research Institute, Chinese Academy of Agricultural Sciences, Beijing 100081, China
| | - Mengqi Wang
- Biotechnology Research Institute, Chinese Academy of Agricultural Sciences, Beijing 100081, China
| | - Caifeng Yang
- Biotechnology Research Institute, Chinese Academy of Agricultural Sciences, Beijing 100081, China
| | - Wenfang Guo
- Biotechnology Research Institute, Chinese Academy of Agricultural Sciences, Beijing 100081, China
| | - Gangqiang Li
- Biotechnology Research Institute, Chinese Academy of Agricultural Sciences, Beijing 100081, China
| | - Sumei Huang
- Biotechnology Research Institute, Guangxi Academy of Agricultural Sciences, Nanning 530007, China
| | - Di Wei
- Biotechnology Research Institute, Guangxi Academy of Agricultural Sciences, Nanning 530007, China
| | - Dehu Liu
- Biotechnology Research Institute, Chinese Academy of Agricultural Sciences, Beijing 100081, China
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Patel A, Figueredo VM. Alcohol and Cardiovascular Disease: Helpful or Hurtful. Rev Cardiovasc Med 2023; 24:121. [PMID: 39076262 PMCID: PMC11273012 DOI: 10.31083/j.rcm2404121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/17/2023] [Accepted: 03/16/2023] [Indexed: 07/31/2024] Open
Abstract
Alcohol has been considered throughout history as both a tonic and a poison. The answer as to which likely depends on one's current health, the amount one consumes, and with what regularity. In examining the relationship of alcohol and cardiovascular health, most, but not all, epidemiological studies suggest that light to moderate alcohol consumption can reduce the incidence of coronary artery disease (CAD), ischemic stroke, and peripheral arterial disease events. Conversely, abuse of alcohol can lead to cardiomyopathy, heart failure, sudden death, and hemorrhagic strokes. In this article, we review the literature studying the effects of alcohol on coronary artery disease and stroke. A recently published study concluded there was no amount of alcohol per day that was heart healthy. Yet more than one hundred previous studies have found that people who drink in moderation have a lower risk of cardiovascular disease events when compared to those who do not drink or drink heavily. Moderate drinking is defined as one to two drinks per day; where one drink is defined as 12 ounces of beer, 5 ounces of wine or 1.5 ounces of hard liquor. In this article we reviewed the data suggesting that consuming alcohol in moderation on a regular basis-as opposed to 7 drinks on Saturday night-could have cardiovascular protective effects.
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Affiliation(s)
- Akash Patel
- Department of Medicine, St Mary Medical Center, Langhorne, PA 19047, USA
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Barbería-Latasa M, Bes-Rastrollo M, Pérez-Araluce R, Martínez-González MÁ, Gea A. Mediterranean Alcohol-Drinking Patterns and All-Cause Mortality in Women More Than 55 Years Old and Men More Than 50 Years Old in the "Seguimiento Universidad de Navarra" (SUN) Cohort. Nutrients 2022; 14:nu14245310. [PMID: 36558468 PMCID: PMC9788476 DOI: 10.3390/nu14245310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Most of the available epidemiological evidence on alcohol and chronic disease agrees on recommending alcohol abstention to young people, but some controversy exists about the most appropriate recommendation for alcohol abstention for people of older ages. A growing body of evidence suggests that the pattern of alcohol consumption is likely to be a strong effect modifier. The Mediterranean Alcohol Drinking Pattern (MADP) represents a score integrating several dimensions of drinking patterns (moderation, preference for red wine, drinking with meals, and avoiding binge drinking). Our aim was to clarify this issue and provide more precise recommendations on alcohol consumption. METHODS We prospectively followed-up 2226 participants (men older than 50 years and women older than 55 years at baseline) in the Seguimiento Universidad de Navarra (SUN) cohort. We classified participants into three categories of adherence to the MADP score (low, moderate, and high), and we added a fourth category for abstainers. Cox regression models estimated multivariable-adjusted hazard ratios (HR) of all-cause death and 95% confidence intervals (CI) using low MADP adherence as the reference category. RESULTS The strongest reduction in risk of mortality was observed for those with high adherence to the MADP, with an HR of 0.54 (95% CI: 0.37-0.80). The moderate adherence group (HR = 0.65, 95% CI: 0.44-0.96) and the abstention group (HR = 0.60, 95% CI: 0.36-0.98) also exhibited lower risks of mortality than the low MADP adherence group. CONCLUSIONS based on the available evidence, a public health message can be provided to people older than 50 years as follows: among those who drink alcohol, high adherence to the MADP score could substantially reduce their risk of all-cause mortality.
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Affiliation(s)
- María Barbería-Latasa
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, 31008 Pamplona, Spain
- Biomedical Research Network Center for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
| | - Rafael Pérez-Araluce
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, 31008 Pamplona, Spain
- Biomedical Research Network Center for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
- Correspondence:
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, 31008 Pamplona, Spain
- Biomedical Research Network Center for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
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Kim M, Kim H, Han K, Yoo J, Yang K, Jeon HJ. Changes in alcohol consumption and the risk of cardiovascular diseases in patients with depression who had not consumed alcohol: A nationwide cohort study. J Psychiatr Res 2022; 155:458-464. [PMID: 36183599 DOI: 10.1016/j.jpsychires.2022.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/01/2022] [Accepted: 09/16/2022] [Indexed: 11/30/2022]
Abstract
Although numerous studies have examined the association between alcohol consumption and cardiovascular diseases (CVDs) in the general population, such association in patients with depression has not been reported yet. Thus, the objective of this study was to examine the association between changes in alcohol consumption and CVDs in patients with depression who had not consumed alcohol. A national database of medical records in South Korea was used and 375,710 subjects newly diagnosed with depression who had not consumed alcohol within two years after the diagnosis of depression (1st point) were identified. Subjects were categorized into three groups (non-drinkers, mild-to-moderate drinkers, and heavy drinkers) based on the status of alcohol intake within two years after the 1st point (2nd point). Subjects were followed up for the occurrence of CVDs including myocardial infarction (MI), ischemic stroke, and all-cause mortality. Among eligible subjects, 329,802 non-drinkers, 43,659 mild-to-moderate drinkers, and 2,249 heavy drinkers were identified. Compared to non-drinkers, heavy drinkers showed increased risks for MI (aHR, 1.41; 95% CI, 1.08-1.83), ischemic stroke (aHR, 1.49; 95% CI, 1.12-1.99), composite CVDs (aHR, 1.48; 95% CI, 1.21-1.80), and all-cause mortality (aHR, 1.38; 95% CI, 1.13-1.68). Compared to those who maintained abstinence from alcohol, those who started heavy drinking after the diagnosis of depression had increased risks of CVDs and all-cause mortality. These data highlight the need for alcohol consumption limitations for people who are diagnosed with depression in clinical settings.
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Affiliation(s)
- Minsoo Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyewon Kim
- Department of Psychiatry, Hanyang University Hospital, Seoul, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Juhwan Yoo
- Department of Biomedicine & Health Science, The Catholic University of Korea, Seoul, South Korea
| | - Kyojin Yang
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Health Sciences & Technology, Department of Medical Device Management & Research, Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
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Barbería-Latasa M, Gea A, Martínez-González MA. Alcohol, Drinking Pattern, and Chronic Disease. Nutrients 2022; 14:1954. [PMID: 35565924 PMCID: PMC9100270 DOI: 10.3390/nu14091954] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/01/2022] [Accepted: 05/05/2022] [Indexed: 12/16/2022] Open
Abstract
This review discusses the inconsistent recommendations on alcohol consumption and its association with chronic disease, highlighting the need for an evidence-based consensus. Alcohol is an addictive substance consumed worldwide, especially in European countries. Recommendations on alcohol consumption are controversial. On one hand, many nonrandomized studies defend that moderate consumption has a beneficial cardiovascular effect or a lower risk of all-cause mortality. On the other hand, alcohol is associated with an increased risk of cancer, neurological diseases, or injuries, among others. For years, efforts have been made to answer the question regarding the safe amount of alcohol intake, but controversies remain. Observational studies advocate moderate alcohol consumption following a Mediterranean pattern (red wine with meals avoiding binge drinking) as the best option for current drinkers. However, agencies such as the IARC recommend abstention from alcohol as it is a potent carcinogen. In this context, more randomized trial with larger sample size and hard clinical endpoints should be conducted to clarify the available evidence and provide clinicians with support for their clinical practice.
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Affiliation(s)
- María Barbería-Latasa
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain; (M.B.-L.); (M.A.M.-G.)
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain; (M.B.-L.); (M.A.M.-G.)
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Biomedical Research Network Center for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
| | - Miguel A. Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain; (M.B.-L.); (M.A.M.-G.)
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Biomedical Research Network Center for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
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Komiyama M, Hasegawa K. Coronavirus Disease 2019: Psychological Stress and Cardiovascular Diseases. Eur Cardiol 2021; 16:e33. [PMID: 34603513 PMCID: PMC8477172 DOI: 10.15420/ecr.2021.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/04/2021] [Indexed: 01/16/2023] Open
Abstract
Minimising deaths due to coronavirus disease 2019 (COVID-19) is a global priority. However, the harmful effects are not limited to those directly related to the infection. The COVID-19 pandemic has also had a serious impact on the mental health of the general population. An increasing number of people are exhibiting signs of depression and an increase in suicides has also been noted around the world. Mental health issues may be linked to starting or increasing the use of addictive substances, such as tobacco, alcohol and drugs, along with increased overweight and obesity resulting from changes in eating habits. These issues can impact cardiovascular diseases because of worsened risk factor control. This review discusses the impact of the COVID-19 pandemic on mental health and cardiovascular risk factors. It will also summarise the measures that can be taken to maintain good mental health and their importance in mitigating cardiovascular disease.
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Affiliation(s)
- Maki Komiyama
- Division of Translational Research, National Hospital Organization Kyoto Medical Center Kyoto, Japan
| | - Koji Hasegawa
- Division of Translational Research, National Hospital Organization Kyoto Medical Center Kyoto, Japan
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Alcohol's Impact on the Cardiovascular System. Nutrients 2021; 13:nu13103419. [PMID: 34684419 PMCID: PMC8540436 DOI: 10.3390/nu13103419] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/21/2022] Open
Abstract
Alcohol consumption has been shown to have complex, and sometimes paradoxical, associations with cardiovascular diseases (CVDs). Several hundred epidemiological studies on this topic have been published in recent decades. In this narrative review, the epidemiological evidence will be examined for the associations between alcohol consumption, including average alcohol consumption, drinking patterns, and alcohol use disorders, and CVDs, including ischaemic heart disease, stroke, hypertension, atrial fibrillation, cardiomyopathy, and heart failure. Methodological shortcomings, such as exposure classification and measurement, reference groups, and confounding variables (measured or unmeasured) are discussed. Based on systematic reviews and meta-analyses, the evidence seems to indicate non-linear relationships with many CVDs. Large-scale longitudinal epidemiological studies with multiple detailed exposure and outcome measurements, and the extensive assessment of genetic and confounding variables, are necessary to elucidate these associations further. Conflicting associations depending on the exposure measurement and CVD outcome are hard to reconcile, and make clinical and public health recommendations difficult. Furthermore, the impact of alcohol on other health outcomes needs to be taken into account. For people who drink alcohol, the less alcohol consumed the better.
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Gobeil K, Medling T, Tavares P, Sawalha K, Abozenah M, Friedmann PD, Naimi T, Pack QR. Frequency of Hazardous and Binge Drinking Alcohol Among Hospitalized Cardiovascular Patients. Am J Cardiol 2021; 153:119-124. [PMID: 34210505 PMCID: PMC8316379 DOI: 10.1016/j.amjcard.2021.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/03/2021] [Accepted: 05/11/2021] [Indexed: 11/19/2022]
Abstract
Excessive alcohol use is a risk factor for most cardiac diseases. The prevalence of unhealthy alcohol use among hospitalized cardiac patients is uncertain as is the frequency with which it is addressed. We performed a single center, patient-level anonymous survey among hospitalized cardiac patients eligible for cardiac rehabilitation. Hazardous drinking was defined as an Alcohol Use Disorders Identification Test (AUDIT) score of 8 or greater. Binge drinking was defined as 5+ drinks for men or 4+ for women on ≥1 occasion within the past 30 days. Unhealthy drinking was defined as either hazardous or binge drinking. Of 300 patients approached, 290 (96.7%) completed the survey. Mean ( ± SD) age was 69 ± 11 years; 70% were male and 31% were cardiac surgical patients. The proportion (95% CI) of hazardous, binge, and unhealthy drinking was 12% (9 to 16), 16% (12 to 20), and 18% (14-23), respectively. Overall, 58% of subjects reported being screened for alcohol use, mostly by nurses (56%). Those with unhealthy drinking reported being counseled more frequently about their alcohol use compared to non-unhealthy drinkers (11% versus 3%, p = 0.03), but the large majority (89%) of unhealthy drinkers reported receiving no advice about their alcohol use while admitted. In conclusion, almost one-fifth of hospitalized cardiac patients reported unhealthy drinking, these patients were only screened about half of the time, and were rarely counseled about their alcohol use.
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Affiliation(s)
- Kyle Gobeil
- Department of Medicine, University of Massachusetts Medical School - Baystate, Springfield Massachusetts; Department of Cardiovascular Disease, University of Massachusetts Medical School - Baystate, Springfield Massachusetts
| | - Theodore Medling
- University of Massachusetts Medical School, Worcester Massachusetts
| | - Paolo Tavares
- University of Massachusetts Medical School, Worcester Massachusetts
| | - Khalid Sawalha
- Department of Medicine, University of Massachusetts Medical School - Baystate, Springfield Massachusetts
| | - Mohammed Abozenah
- Department of Medicine, University of Massachusetts Medical School - Baystate, Springfield Massachusetts
| | - Peter D Friedmann
- Department of Medicine, University of Massachusetts Medical School - Baystate, Springfield Massachusetts; Institute of Healthcare Delivery and Population Science, University of Massachusetts Medical School - Baystate, Springfield Massachusetts
| | - Timothy Naimi
- Department of Medicine, Boston University School of Medicine, Boston Massachusetts
| | - Quinn R Pack
- Department of Medicine, University of Massachusetts Medical School - Baystate, Springfield Massachusetts; Department of Cardiovascular Disease, University of Massachusetts Medical School - Baystate, Springfield Massachusetts; Institute of Healthcare Delivery and Population Science, University of Massachusetts Medical School - Baystate, Springfield Massachusetts.
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A Matched Control Analysis on the Effects of Alcohol Use Disorder After Primary Total Knee Arthroplasty in Medicare Patients. J Am Acad Orthop Surg 2021; 29:e593-e600. [PMID: 32991387 DOI: 10.5435/jaaos-d-20-00466] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/24/2020] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Several studies have found the negative impact of alcohol use disorder (AUD), most notably coagulation derangements. We sought to investigate the effects of AUD after primary total knee arthroplasty (TKA) for (1) postoperative complications, (2) lengths of stay, and (3) costs of care. METHODS This was a retrospective database analysis of Medicare patients with AUD undergoing primary TKA performed between 2005 and 2014. Patients with AUD were matched to controls in a 1:5 ratio by age, sex, and medical comorbidities. The query yielded 354,690 TKA patients: 59,126 with AUD and 295,564 without AUD. RESULTS Patients with AUD had significantly greater odds ratio (OR) of medical complications, including venous thromboembolism (VTE) within 90 days (OR: 1.41, P < 0.0001) and at 1 year (OR: 1.51, P < 0.0001) and greater 2-year implant-related complications after primary TKA. Furthermore, patients with AUD had significantly longer lengths of stay (4 versus 3 days, P < 0.0001) and incurred a significantly higher episode of care costs ($15,569.76 versus $13,763.06, P < 0.0001). DISCUSSION The present study demonstrated a significant association between AUD and the development of VTE. We hope this research will aid in risk stratification and tailoring of VTE chemoprophylaxis and postoperative management in this at-risk group after TKA. LEVEL OF EVIDENCE Level III.
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Cardiac Mitochondrial PTEN-L determines cell fate between apoptosis and survival during chronic alcohol consumption. Apoptosis 2021; 25:590-604. [PMID: 32591959 DOI: 10.1007/s10495-020-01616-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chronic alcohol consumption induces myocardial damage and a type of non-ischemic cardiomyopathy termed alcoholic cardiomyopathy, where mitochondrial ultrastructural damages and suppressed fusion activity promote cardiomyocyte apoptosis. The aim of the present study is to determine the role of mitochondrial fission proteins and/or other proteins that localise on cardiac mitochondria for apoptosis upon ethanol consumption. In vivo and in vitro chronic alcohol exposure increased mitochondrial Drp1 levels but knockdown of the same did not confer cardioprotection in H9c2 cells. These cells displayed downregulated expression of MFN2 and OPA1 for Bak-mediated cytochrome c release and apoptosis. Dysregulated PTEN/AKT cell survival signal in both ethanol treated and Drp1 knockdown cells augmented oxidative stress by promoting mitochondrial PTEN-L and MFN1 interaction. Inhibiting this interaction with VO-OHpic, a reversible PTEN inhibitor, prevented Bak insertion into the mitochondria and release of cytochrome c to cytoplasm. Thus, our study provides evidence that Drp1-mediated mitochondrial fission is dispensable for ethanol-induced cardiotoxicity and that stress signals induce mitochondrial PTEN-L accumulation for structural and functional dyshomeostasis. Our in vivo results also demonstrates the therapeutic potential of VO-OHpic for habitual alcoholics developing myocardial dysfunction.
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Kadri AN, Khodor S, Ali A, Nusairat L, Mahmood A, Nahhas G, Dabbous S, Spears J, Jafri S, Werns S. National Trends of Tobacco, Alcohol, and Drug Use in Patients Admitted With Acute Myocardial Infarction. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2021; 26:26-31. [PMID: 33229134 DOI: 10.1016/j.carrev.2020.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Acute myocardial infarction (AMI) is a significant health and economic burden in the US. Tobacco, alcohol, and drug use are established risk factors. We sought to evaluate the national trend of use of each substance in patients admitted with AMI. METHODS We used the National Inpatient Sample between 2005 and 2017. We included adult patients hospitalized with AMI. International Classification of Diseases, Ninth and Tenth Revisions codes were used to define tobacco, alcohol, cocaine, opioid, cannabis and other drug use. Trends of each substance use were assessed using multivariable Poisson regression, and were expressed as annual percent change (APC) with their 95% confidence intervals (CIs). RESULTS A total of 10,796,844 hospitalizations with AMI were included. Among all substances used, tobacco was the most common (32.7%), followed by alcohol (3.2%). Between 2005 and 2017, the prevalence ratio of tobacco use increased from 21.5% to 44.5% with an APC +6.2% (95%CI 6.2%-6.2%). Tobacco users had more percutaneous coronary intervention (41%vs25%) and coronary artery bypass surgery (6.9%vs4.9%), p < 0.001. Further, there were positive trends in alcohol (APC +3.1%; 95%CI 3.0%-3.2%), opioid (APC +9.0%; 95%CI 8.7%-9.2%), cannabis (APC + 7.2; 95% CI 7%-7.4%), and combined all drug use (+7.1%; 95%CI 7%-7.2%). Meanwhile, there was a slight negative trend in cocaine use. CONCLUSIONS This analysis outlines the national trends of substance use in patients admitted with AMI and reveals an increasing prevalence of tobacco use, alcohol and drug use. More effective cessation measures are necessary to reduce the risk for AMI and its burden on the healthcare system and economy.
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Reddiess P, Aeschbacher S, Meyre P, Coslovsky M, Kühne M, Rodondi N, Baretella O, Beer JH, Kobza R, Moschovitis G, Di Valentino M, Müller C, Steiner F, Bonati LH, Sticherling C, Osswald S, Conen D. Alcohol consumption and risk of cardiovascular outcomes and bleeding in patients with established atrial fibrillation. CMAJ 2021; 193:E117-E123. [PMID: 33667180 PMCID: PMC7954562 DOI: 10.1503/cmaj.200778] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND: Little is known about the association between alcohol consumption and risk of cardiovascular events in patients with established atrial fibrillation (AF). The main aim of the current study was to investigate the associations of regular alcohol intake with incident stroke or systemic embolism in patients with established AF. METHODS: To assess the association between alcohol consumption and cardiovascular events in patients with established AF, we combined data from 2 comparable prospective cohort studies that followed 3852 patients with AF for a median of 3.0 years. Patients were grouped into 4 categories of daily alcohol intake (none, > 0 to < 1, 1 to < 2 and ≥ 2 drinks/d). The primary outcome was a composite of stroke and systemic embolism. Secondary outcomes were all-cause mortality, myocardial infarction, hospital admission for acute heart failure, and a composite of major and clinically relevant nonmajor bleeding. Associations were assessed using time-updated, multivariable-adjusted Cox proportional hazards models. RESULTS: Mean age (± standard deviation) was 71 ± 10 years (28% were women and 84% were on oral anticoagulants). We observed 136 confirmed strokes or systemic emboli. Compared with nondrinkers, adjusted hazard ratios for the primary outcome event were 0.87, 95% confidence interval (CI) 0.55–1.37 for > 0 to < 1 drinks/d; 0.70, 95% CI 0.39–1.25 for 1 to < 2 drinks/d; and 0.96, 95% CI 0.56–1.67 for ≥ 2 drinks/d (p for linear [quadratic] trend 0.71 [0.22]). There was no significant association between alcohol consumption and bleeding, but there was a nonlinear association with heart failure (p for quadratic trend 0.01) and myocardial infarction (p for quadratic trend 0.007). INTERPRETATION: In patients with AF, we did not find a significant association between low to moderate alcohol intake and risk of stroke or other cardiovascular events. Our findings do not support special recommendations for patients with established AF with regard to alcohol consumption. Trial registration: ClinicalTrials.gov, no. NCT02105844
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Affiliation(s)
- Philipp Reddiess
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Pascal Meyre
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Michael Coslovsky
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Michael Kühne
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Nicolas Rodondi
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Oliver Baretella
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Jürg H Beer
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Richard Kobza
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Giorgio Moschovitis
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Marcello Di Valentino
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Cyrill Müller
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Fabienne Steiner
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Leo H Bonati
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Christian Sticherling
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - Stefan Osswald
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont
| | - David Conen
- Cardiovascular Research Institute Basel (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald, Conen); Cardiology Division (Reddiess, Aeschbacher, Meyre, Coslovsky, Kühne, Müller, Steiner, Sticherling, Osswald); Clinical Trial Unit Basel, Department of Clinical Research (Coslovsky), University Hospital Basel, Switzerland; Institute of Primary Health Care (BIHAM) (Rodondi), University of Bern; Department of General Internal Medicine (Rodondi), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medicine (Beer), Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland; Department of Cardiology (Kobza), Luzerner Kantonsspital, Switzerland; Department of Cardiology (Moschovitis), EOC Ospedale Regionale di Lugano, Switzerland; Department of Cardiology (Di Valentino), EOC Ospedale San Giovanni, Bellinzona, Switzerland; Department of Neurology and Stroke Center (Bonati), University Hospital Basel, University of Basel, Switzerland; Population Health Research Institute (Conen), McMaster University, Hamilton, Ont.
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Grønbæk M, Ellison RC, Skovenborg E. The J-shaped curve-conceptual and methodological challenges. DRUGS AND ALCOHOL TODAY 2021. [DOI: 10.1108/dat-09-2020-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to review the conceptual and methodological challenges of a J-shaped association between alcohol consumption (AC), coronary heart disease (CHD) and all-cause mortality. In associated papers in this journal, Skovenborg et al., 2021 reviews the evidence for the J-shaped curve, and Ellison et al., 2021 examines the advantages and drawbacks of Mendelian randomization studies of the J-shaped curve.
Design/methodology/approach
A number of methodological problems are common in observational research in general, and some of the methodological problems suggested for the J-shaped alcohol-CHD-associations are discussed. The extent of the methodological problems in studies of the J-shaped curve is reviewed, and the possibility that the J-shaped curve is an artifact created by reverse causality and residual confounding is discussed. Further, the issue of interaction with drinking pattern and type of alcohol is discussed.
Findings
Imprecise categorization of alcohol intake information seems to have had little effect on the J-shaped alcohol-CHD-associations, nor has it affected the ability of these studies to show increasing mortality from a range of causes with increasing AC. The problem of “sick quitters” has been resolved by large studies using lifelong abstainers or infrequent drinkers as reference group. Many studies lack information on drinking patterns with regard to regular, moderate consumption versus binge drinking. Stratified analyses by important risk factors for CHD have not significantly changed the J-shaped association observed in most epidemiologic studies.
Originality/value
Potential biases and residual confounding probably do not overcome the J-shaped alcohol-CDH-association observed in most epidemiologic studies; however, the existence of a J-shaped curve is challenged by some degree of uncertainty. The actual review together with the associated papers by Skovenborg et al., 2021 and Ellison et al., 2021 offers a possibility to “update your priors” and achieve greater certainty when giving your patients information on the pros and cons of alcohol intake.
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Goldwater D, Karlamangla A, Merkin SS, Seeman T. Compared to non-drinkers, individuals who drink alcohol have a more favorable multisystem physiologic risk score as measured by allostatic load. PLoS One 2019; 14:e0223168. [PMID: 31568479 PMCID: PMC6768542 DOI: 10.1371/journal.pone.0223168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/13/2019] [Indexed: 01/11/2023] Open
Abstract
Aims Alcohol use is associated with both positive and negative effects on individual cardiovascular risk factors, depending upon which risk factor is assessed. The present analysis uses a summative multisystem index of biologic risk, known as allostatic load (AL), to evaluate whether the overall balance of alcohol-associated positive and negative cardiovascular risk factors may be favorable or unfavorable. Methods This analysis included 1255 adults from the Midlife in the United States (MIDUS) biomarker substudy. Participants, average age 54.5 (±11) years, were divided into 6 alcohol-use categories based on self-reported drinking habits. Current non-drinkers were classified as lifelong abstainers and former light drinkers, former moderate drinkers, or former heavy drinkers. Current alcohol users were classified as light, moderate, or heavy drinkers. A total AL score was calculated using 24 biomarkers grouped into 7 physiologic systems including cardiovascular, inflammation, glucose metabolism, lipid metabolism, sympathetic and parasympathetic nervous systems, and the hypothalamic-pituitary-adrenal axis. Mixed-effects regression models were fit to determine the relationship between alcohol use categories and AL with controls for covariates that may influence the relationship between alcohol use and AL. Results 468 (37.6%) individuals were current non-drinkers while 776 (62.4%) were current drinkers. In adjusted mixed-effects regression models, all 3 groups of current drinkers had significantly lower average AL scores than the lifelong abstainer/former light drinker group (light: -0.23, 95% CI -0.40, -0.07, p < 0.01; moderate: -0.20, 95% CI -0.38, -0.02, p < 0.05; heavy: -0.30, 95% CI -0.57, -0.04, p < 0.05), while the average AL scores of former moderate and former heavy drinkers did not differ from the lifelong abstainer/former light drinker group. Conclusions Current alcohol use is associated cross-sectionally with a favorable multisystem physiologic score known to be associated with better long-term health outcomes, providing evidence in support of long-term health benefits related to alcohol consumption.
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Affiliation(s)
- Deena Goldwater
- Department of Medicine, Division of Geriatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
- * E-mail:
| | - Arun Karlamangla
- Department of Medicine, Division of Geriatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| | - Sharon Stein Merkin
- Department of Medicine, Division of Geriatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| | - Teresa Seeman
- Department of Medicine, Division of Geriatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
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Alam I, Almajwal AM, Alam W, Alam I, Ullah N, Abulmeaaty M, Razak S, Khan S, Pawelec G, Paracha PI. The immune-nutrition interplay in aging – facts and controversies. ACTA ACUST UNITED AC 2019. [DOI: 10.3233/nha-170034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Iftikhar Alam
- Department of Community Health Sciences, Clinical Nutrition Program, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Department of Human Nutrition & Dietetics, Bacha Khan University Charsadda, Charsadda, Khyber Pakhtunkhwa, Pakistan
- Tübingen Ageing and Tumour Immunology Group, Zentrum für Medizinische Forschung, University of Tübingen, Tübingen, Germany
| | - Ali M. Almajwal
- Department of Community Health Sciences, Clinical Nutrition Program, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Wajid Alam
- Oral and Maxillofacial Surgery, Khyber Colleg of Dentistry, KPK, Peshawar, Pakistan
| | - Ibrar Alam
- Department of Biotechnology, Bacha Khan University Charsadda, Charsadda, Khyber Pakhtunkhwa, Pakistan
| | - Niamat Ullah
- Department of Human Nutrition, The Agriculture University Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Mahmoud Abulmeaaty
- Department of Community Health Sciences, Clinical Nutrition Program, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Suhail Razak
- Department of Community Health Sciences, Clinical Nutrition Program, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Saleem Khan
- Department of Human Nutrition, The Agriculture University Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Graham Pawelec
- Tübingen Ageing and Tumour Immunology Group, Zentrum für Medizinische Forschung, University of Tübingen, Tübingen, Germany
- Health Sciences North Research Institute, Sudbury, ON, Canada
- John van Geest Cancer Research Centre, Nottingham Trent University, Nottingham, UK
| | - Parvez Iqbal Paracha
- Department of Human Nutrition, The Agriculture University Peshawar, Khyber Pakhtunkhwa, Pakistan
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Díaz-Gutiérrez J, Ruiz-Estigarribia L, Bes-Rastrollo M, Ruiz-Canela M, Martin-Moreno JM, Martínez-González MA. The role of lifestyle behaviour on the risk of hypertension in the SUN cohort: The hypertension preventive score. Prev Med 2019; 123:171-178. [PMID: 30902699 DOI: 10.1016/j.ypmed.2019.03.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/05/2019] [Accepted: 03/16/2019] [Indexed: 11/29/2022]
Abstract
Lifestyles may influence the risk of hypertension. Our objective was to assess the association between a healthy-lifestyle score and the incidence of hypertension. The SUN Project is a dynamic, prospective cohort of Spanish university graduates (1999-2014). Among 14,057 participants initially free of hypertension, we assessed the influence of lifestyle-related factors based on a 10-item score that we previously reported to be associated with lower risk of major cardiovascular events. However, we focused on factors related to hypertension risk according to previous scientific evidence and international clinical guidelines and constructed a 6-item score including: no smoking, moderate-to-high physical activity, Mediterranean diet adherence, healthy body mass index, moderate alcohol intake and no binge drinking. We fitted Cox regression models to adjust for potential confounders. During a median follow-up of 10.2 years, we identified 1406 incident cases of medically diagnosed hypertension. The risk of developing hypertension was linearly reduced as participants better adhered to a healthy lifestyle pattern built by summing up these 6 factors (p for trend<0.001). The highest category (5-6 factors) exhibited a significant 46% relative reduction in the risk of developing hypertension compared to the lowest category (0-1 factors) (multivariable-adjusted hazard ratio = 0.54; 95% CI: 0.42-0.68). Among the components of the score, BMI was apparently the main factor driving the association between the HLS and lower risk of hypertension. A healthy-lifestyle score including six simple healthy habits was longitudinally and linearly associated with a substantially reduced risk of hypertension. This index may be a useful tool for hypertension prevention.
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Affiliation(s)
- Jesús Díaz-Gutiérrez
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain.
| | - Liz Ruiz-Estigarribia
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain.
| | - Maira Bes-Rastrollo
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; CIBER Pathophysiology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain; IDISNA Navarra's Health Research Institute, Pamplona, Spain.
| | - Miguel Ruiz-Canela
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; CIBER Pathophysiology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain; IDISNA Navarra's Health Research Institute, Pamplona, Spain.
| | - José M Martin-Moreno
- University of Valencia, Department of Preventive Medicine and Public Health, University Clinical Hospital-INCLIVA, Valencia, Spain.
| | - Miguel A Martínez-González
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; CIBER Pathophysiology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain; IDISNA Navarra's Health Research Institute, Pamplona, Spain; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States.
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Mitochondrial Aldehyde Dehydrogenase in Myocardial Ischemic and Ischemia-Reperfusion Injury. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1193:107-120. [PMID: 31368100 DOI: 10.1007/978-981-13-6260-6_6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Myocardial ischemia-reperfusion (IR) injury during acute myocardial infarction or open-heart surgery would promote oxidative stress, leading to the accumulation of reactive aldehydes that cause cardiac damage. It has been well demonstrated that aldehyde dehydrogenase (ALDH)-2 is an important cardioprotective enzyme for its central role in the detoxification of reactive aldehydes. ALDH2 activation by small molecule activators is a promising approach for cardioprotection for myocardial IR injury.
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Lee K. Sex-Specific Associations of Risk-Based Alcohol Drinking Level with Cardiovascular Risk Factors and the 10-Year Cardiovascular Disease Risk Scores. Alcohol Clin Exp Res 2018; 42:1503-1510. [PMID: 29852058 DOI: 10.1111/acer.13798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 05/17/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND To assess sex-specific associations between risk-based alcohol drinking levels and the 10-year cardiovascular disease (CVD) risk scores and cardiovascular (CV) risk factors. METHODS Data from 9,995 Koreans (4,249 men, 5,746 women), aged 40 to 79 years who did not have CVD and participated in the 2011 to 2013 Korea National Health and Nutrition Examination Survey, were used to assess risk-based alcohol drinking levels in the past year (no drinking, drinking at low risk, and drinking at risk) categorized by the National Institute on Alcohol Abuse and Alcoholism, components of the 10-year CVD risk scores using the Adult Treatment Panel III risk score and the 10-year hard atherosclerotic CVD risk score, CV risk factors, and confounding factors (age, smoking status, body mass index, educational attainment, income level, and physical activity). RESULTS Drinking levels had positive associations with blood pressure and levels of glucose, triglycerides, and high-density lipoprotein cholesterol (HDL-C) and inverse associations with levels of low-density lipoprotein cholesterol and non-HDL-C and ratio of total cholesterol (TC) to HDL-C in men, while higher drinking levels were associated with higher HDL-C levels and lower ratio of TC to HDL-C in women after adjusting for confounding factors (p for trend < 0.001). With respect to the 10-year CVD risk scores, higher drinking levels were associated with lower scores in both sexes (p for trend < 0.001). CONCLUSIONS Risk-based drinking levels were more likely to have dose-dependent associations with CV risk factors in men than in women and had inverse relationships with 10-year CVD risk in both men and women.
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Affiliation(s)
- Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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20
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Alcohol and CV Health: Jekyll and Hyde J-Curves. Prog Cardiovasc Dis 2018; 61:68-75. [DOI: 10.1016/j.pcad.2018.02.001] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 02/11/2018] [Indexed: 12/16/2022]
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21
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Wood AM, Kaptoge S, Butterworth AS, Willeit P, Warnakula S, Bolton T, Paige E, Paul DS, Sweeting M, Burgess S, Bell S, Astle W, Stevens D, Koulman A, Selmer RM, Verschuren WMM, Sato S, Njølstad I, Woodward M, Salomaa V, Nordestgaard BG, Yeap BB, Fletcher A, Melander O, Kuller LH, Balkau B, Marmot M, Koenig W, Casiglia E, Cooper C, Arndt V, Franco OH, Wennberg P, Gallacher J, de la Cámara AG, Völzke H, Dahm CC, Dale CE, Bergmann MM, Crespo CJ, van der Schouw YT, Kaaks R, Simons LA, Lagiou P, Schoufour JD, Boer JMA, Key TJ, Rodriguez B, Moreno-Iribas C, Davidson KW, Taylor JO, Sacerdote C, Wallace RB, Quiros JR, Tumino R, Blazer DG, Linneberg A, Daimon M, Panico S, Howard B, Skeie G, Strandberg T, Weiderpass E, Nietert PJ, Psaty BM, Kromhout D, Salamanca-Fernandez E, Kiechl S, Krumholz HM, Grioni S, Palli D, Huerta JM, Price J, Sundström J, Arriola L, Arima H, Travis RC, Panagiotakos DB, Karakatsani A, Trichopoulou A, Kühn T, Grobbee DE, Barrett-Connor E, van Schoor N, Boeing H, Overvad K, Kauhanen J, Wareham N, Langenberg C, Forouhi N, Wennberg M, Després JP, Cushman M, Cooper JA, Rodriguez CJ, Sakurai M, Shaw JE, Knuiman M, Voortman T, Meisinger C, Tjønneland A, Brenner H, Palmieri L, Dallongeville J, Brunner EJ, Assmann G, Trevisan M, Gillum RF, Ford I, Sattar N, Lazo M, Thompson SG, Ferrari P, Leon DA, Smith GD, Peto R, Jackson R, Banks E, Di Angelantonio E, Danesh J. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet 2018; 391:1513-1523. [PMID: 29676281 PMCID: PMC5899998 DOI: 10.1016/s0140-6736(18)30134-x] [Citation(s) in RCA: 741] [Impact Index Per Article: 123.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/03/2017] [Accepted: 12/05/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Low-risk limits recommended for alcohol consumption vary substantially across different national guidelines. To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, we studied individual-participant data from 599 912 current drinkers without previous cardiovascular disease. METHODS We did a combined analysis of individual-participant data from three large-scale data sources in 19 high-income countries (the Emerging Risk Factors Collaboration, EPIC-CVD, and the UK Biobank). We characterised dose-response associations and calculated hazard ratios (HRs) per 100 g per week of alcohol (12·5 units per week) across 83 prospective studies, adjusting at least for study or centre, age, sex, smoking, and diabetes. To be eligible for the analysis, participants had to have information recorded about their alcohol consumption amount and status (ie, non-drinker vs current drinker), plus age, sex, history of diabetes and smoking status, at least 1 year of follow-up after baseline, and no baseline history of cardiovascular disease. The main analyses focused on current drinkers, whose baseline alcohol consumption was categorised into eight predefined groups according to the amount in grams consumed per week. We assessed alcohol consumption in relation to all-cause mortality, total cardiovascular disease, and several cardiovascular disease subtypes. We corrected HRs for estimated long-term variability in alcohol consumption using 152 640 serial alcohol assessments obtained some years apart (median interval 5·6 years [5th-95th percentile 1·04-13·5]) from 71 011 participants from 37 studies. FINDINGS In the 599 912 current drinkers included in the analysis, we recorded 40 310 deaths and 39 018 incident cardiovascular disease events during 5·4 million person-years of follow-up. For all-cause mortality, we recorded a positive and curvilinear association with the level of alcohol consumption, with the minimum mortality risk around or below 100 g per week. Alcohol consumption was roughly linearly associated with a higher risk of stroke (HR per 100 g per week higher consumption 1·14, 95% CI, 1·10-1·17), coronary disease excluding myocardial infarction (1·06, 1·00-1·11), heart failure (1·09, 1·03-1·15), fatal hypertensive disease (1·24, 1·15-1·33); and fatal aortic aneurysm (1·15, 1·03-1·28). By contrast, increased alcohol consumption was log-linearly associated with a lower risk of myocardial infarction (HR 0·94, 0·91-0·97). In comparison to those who reported drinking >0-≤100 g per week, those who reported drinking >100-≤200 g per week, >200-≤350 g per week, or >350 g per week had lower life expectancy at age 40 years of approximately 6 months, 1-2 years, or 4-5 years, respectively. INTERPRETATION In current drinkers of alcohol in high-income countries, the threshold for lowest risk of all-cause mortality was about 100 g/week. For cardiovascular disease subtypes other than myocardial infarction, there were no clear risk thresholds below which lower alcohol consumption stopped being associated with lower disease risk. These data support limits for alcohol consumption that are lower than those recommended in most current guidelines. FUNDING UK Medical Research Council, British Heart Foundation, National Institute for Health Research, European Union Framework 7, and European Research Council.
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Affiliation(s)
- Angela M Wood
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
| | - Stephen Kaptoge
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Adam S Butterworth
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Peter Willeit
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Medical University Innsbruck, Innsbruck, Austria
| | - Samantha Warnakula
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Thomas Bolton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Ellie Paige
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Dirk S Paul
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Michael Sweeting
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen Burgess
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; MRC Biostatistics Unit, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Steven Bell
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - William Astle
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - David Stevens
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Albert Koulman
- NIHR BRC Nutritional Biomarker Laboratory, University of Cambridge, Cambridge, UK
| | | | - W M Monique Verschuren
- National Institute for Public Health and the Environment, Bilthoven, Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Shinichi Sato
- Chiba Prefectural Institute of Public Health, Chiba, Japan
| | - Inger Njølstad
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Mark Woodward
- Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, UK; The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Veikko Salomaa
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Børge G Nordestgaard
- Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bu B Yeap
- School of Medicine, University of Western Australia, Perth, WA, Australia; Fiona Stanley Hospital, Perth, WA, Australia; Harry Perkins Institute of Medical Research, Perth, WA, Australia
| | | | - Olle Melander
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Lewis H Kuller
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Michael Marmot
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Wolfgang Koenig
- 92 Deutsches Herzzentrum München, Technische Universität München, Munich, Germany, DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany; University of Ulm Medical Center, Ulm, Germany
| | | | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Volker Arndt
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Oscar H Franco
- Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - John Gallacher
- Department of Primary Care and Public Health, Cardiff University, Cardiff, UK
| | | | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | | | - Caroline E Dale
- Farr Institute of Health Informatics Research, UCL Institute of Health Informatics, University College London, London, UK
| | | | - Carlos J Crespo
- School of Community Health, Portland State University, Portland, OR, USA
| | - Yvonne T van der Schouw
- Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Rudolf Kaaks
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Leon A Simons
- St Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Pagona Lagiou
- Hellenic Health Foundation, Athens, Greece; National and Kapodistrian University of Athens, Athens, Greece; Harvard TH Chan School of Public Health, Boston, MA, USA
| | | | - Jolanda M A Boer
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Timothy J Key
- Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Beatriz Rodriguez
- Office of Public Health Studies, University of Hawaii, Honolulu, HI, USA
| | - Conchi Moreno-Iribas
- Instituto de Salud Pública de Navarra, IdiSNA - Navarra Institute for Health Research, Pamplona, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, Spain
| | | | | | | | - Robert B Wallace
- College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - J Ramon Quiros
- Consejería de Sanidad del Principado de Asturias, Oviedo, Asturias, Spain
| | | | - Dan G Blazer
- Duke Divinity School, Duke University, Durham, NC, USA
| | - Allan Linneberg
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Makoto Daimon
- Global Center of Excellence Program Study Group, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Salvatore Panico
- Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy
| | | | - Guri Skeie
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Timo Strandberg
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Elisabete Weiderpass
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Paul J Nietert
- Medical University of South Carolina, Charleston, SC, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle, WA, USA; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Daan Kromhout
- Department of Agrotechnology and Food Sciences, University of Wageningen, Wageningen, Netherlands; Faculty of Medical Sciences, University of Groningen, Groningen, Netherlands
| | - Elena Salamanca-Fernandez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | | | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Domenico Palli
- Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - José M Huerta
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Jackie Price
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Johan Sundström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Larraitz Arriola
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto BIO-Donostia, Basque Government, San Sebastian, Spain
| | - Hisatomi Arima
- The University of Sydney and Royal Prince Alfred Hospital, Sydney, NSW, Australia; Department of Preventive Medicine and Public Health, Kyushu University, Fukuoka, Japan
| | - Ruth C Travis
- Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, UK
| | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece; National and Kapodistrian University of Athens, Athens, Greece
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece; National and Kapodistrian University of Athens, Athens, Greece
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Diederick E Grobbee
- Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Natasja van Schoor
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands
| | - Heiner Boeing
- German Institute of Human Nutrition, Potsdam-Rehbrüke, Germany
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark; Aalborg University Hospital, Aalborg, Denmark
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Nick Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Claudia Langenberg
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Nita Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Maria Wennberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Mary Cushman
- Department of Medicine, University of Vermont, Burlington, VT, USA
| | - Jackie A Cooper
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Carlos J Rodriguez
- Wake Forest University School of Medicine, Winston-Salem, NC, USA; Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Jonathan E Shaw
- Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Matthew Knuiman
- Busselton Population Medical Research Institute, Busselton, WA, Australia; School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Trudy Voortman
- Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Christa Meisinger
- Helmholtz Zentrum München German Research Center for Environmental Health, Germany
| | | | - Hermann Brenner
- German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, University of Heidelberg, Heidelberg, Germany
| | | | | | - Eric J Brunner
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Gerd Assmann
- Assmann-Stiftung für Prävention, Münster, Germany
| | | | | | - Ian Ford
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Mariana Lazo
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Simon G Thompson
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Pietro Ferrari
- International Agency for Research on Cancer, Lyon, France
| | - David A Leon
- London School of Hygiene & Tropical Medicine, London, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Richard Peto
- Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Rod Jackson
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | | | - John Danesh
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
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Abstract
PURPOSE OF REVIEW This review aims to discuss the effect of alcohol consumption on various cardiovascular (CV) diseases and CV mortality. RECENT FINDINGS Alcohol intake has consistently shown a J- or U-shaped relationship with several cardiovascular diseases. Light to moderate alcohol intake has been associated with lower risk of coronary artery disease, heart failure (HF), as well as CV mortality. On the other hand, heavy consumption has been associated with deleterious CV outcomes including increased mortality. However, the evidence is based from observational and population-based studies where risk of confounding cannot be excluded even after meticulous methodological approaches. This is compounded by conflicting data such as higher risk of certain CV diseases like HF in former drinkers compared to abstainers. Further, Mendelian randomization studies using genetic polymorphisms in enzymes have recently questioned the beneficial association of low-moderate drinking with CV system. There has been substantial and consistent evidence that light to moderate alcohol consumption have beneficial effect on overall cardiovascular profile and mortality. However, there are considerable limitations in the reported literature to determine a strong causality of a protective effect of moderate alcohol consumption by itself. Further robust studies or possibly a well-structured randomized controlled could bring an end to this debate.
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Affiliation(s)
- Sunny Goel
- Division of Cardiovascular Medicine, Maimonides Medical Center, Brooklyn, NY, USA
| | - Abhishek Sharma
- Division of Cardiovascular Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
- Institute of Cardiovascular Research and Technology, Brooklyn, NY, USA.
| | - Aakash Garg
- Rutgers Robert Wood Johnson Medical School, 69 Duke Street, New Brunswick, NJ, USA
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Mehta LS, Watson KE, Barac A, Beckie TM, Bittner V, Cruz-Flores S, Dent S, Kondapalli L, Ky B, Okwuosa T, Piña IL, Volgman AS. Cardiovascular Disease and Breast Cancer: Where These Entities Intersect: A Scientific Statement From the American Heart Association. Circulation 2018; 137:e30-e66. [PMID: 29437116 PMCID: PMC6722327 DOI: 10.1161/cir.0000000000000556] [Citation(s) in RCA: 479] [Impact Index Per Article: 79.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardiovascular disease (CVD) remains the leading cause of mortality in women, yet many people perceive breast cancer to be the number one threat to women's health. CVD and breast cancer have several overlapping risk factors, such as obesity and smoking. Additionally, current breast cancer treatments can have a negative impact on cardiovascular health (eg, left ventricular dysfunction, accelerated CVD), and for women with pre-existing CVD, this might influence cancer treatment decisions by both the patient and the provider. Improvements in early detection and treatment of breast cancer have led to an increasing number of breast cancer survivors who are at risk of long-term cardiac complications from cancer treatments. For older women, CVD poses a greater mortality threat than breast cancer itself. This is the first scientific statement from the American Heart Association on CVD and breast cancer. This document will provide a comprehensive overview of the prevalence of these diseases, shared risk factors, the cardiotoxic effects of therapy, and the prevention and treatment of CVD in breast cancer patients.
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Knott CS, Bell S, Britton A. The stability of baseline-defined categories of alcohol consumption during the adult life-course: a 28-year prospective cohort study. Addiction 2018; 113:34-43. [PMID: 28734088 PMCID: PMC5725237 DOI: 10.1111/add.13949] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/10/2017] [Accepted: 07/14/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIMS Studies that report the relationship between alcohol consumption and disease risk have predominantly operationalized drinking according to a single baseline measure. The resulting assumption of longitudinal stability may be simplistic and complicate interpretation of risk estimates. This study aims to describe changes to the volume of consumption during the adult life-course according to baseline categories of drinking. DESIGN A prospective observational study. SETTING United Kingdom. PARTICIPANTS A cohort of British civil servants totalling 6838 men and 3372 women aged 34-55 years at baseline, followed for a mean 19.1 (standard deviation = 9.5) years. MEASUREMENTS The volume of weekly alcohol consumption was estimated from data concerning the frequency and number of drinks consumed. Baseline categories were defined: non-current drinkers, infrequent drinkers, 0.1-50.0 g/week, 50.1-100.0 g/week, 100.1-150.0 g/week, 150.1-250.0 g/week and >250.0 g/week. For women, the highest category was defined as > 100.0 g/week. Baseline frequency was derived as 'daily or almost daily' and 'not daily or almost daily'. Trajectories were estimated within baseline categories using growth curve models. FINDINGS Trajectories differed between men and women, but were relatively stable within light-to-moderate categories of baseline consumption. Drinking was least stable within the highest categories of baseline consumption (men: > 250.0 g/week; women: > 100.0 g/week), declining by 47.0 [95% confidence interval (CI) = 40.7, 53.2] and 16.8 g/week (95% CI = 12.6, 21.0), respectively, per 10-year increase in age. These declines were not a consequence of sudden transitions to complete abstention. Rates of decline appear greatest in older age, with trajectories converging toward moderate volumes. CONCLUSION Among UK civil servants, consumption within baseline drinking categories is generally stable during the life-course, except among heavier baseline drinkers, for whom intakes decline with increasing age. This shift does not appear to be driven by transitions to non-drinking. Cohorts of older people may be at particular risk of misclassifying former heavy drinkers as moderate consumers of alcohol.
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Affiliation(s)
- Craig S. Knott
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK,MRC Epidemiology Unit and Centre for Diet and Activity Research (CEDAR)University of Cambridge School of Clinical MedicineCambridgeUK
| | - Steven Bell
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK,Department of Public Health and Primary Care, Strangeways Research LaboratoryUniversity of CambridgeCambridgeUK
| | - Annie Britton
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
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Wilsnack RW, Wilsnack SC, Gmel G, Kantor LW. Gender Differences in Binge Drinking. Alcohol Res 2018; 39:57-76. [PMID: 30557149 PMCID: PMC6104960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Just as binge drinking rates differ for men and women, the predictors and consequences of binge drinking vary by gender as well. This article examines these differences and how binge drinking definitions and research samples and methods may influence findings. It also describes the relationship between age and binge drinking among men and women, and how drinking culture and environment affect this relationship. It examines gender-specific trends in binge drinking, predictors of binge drinking for men and women, and binge drinking in the context of smoking. The article reviews current findings on gender differences in the health consequences of binge drinking, including morbidity and mortality, suicidality, cancer, cardiovascular disorders, liver disorders, and brain and neurocognitive implications. It also discusses gender differences in the behavioral and social consequences of binge drinking, including alcohol-impaired driving, sexual assault, and intimate partner violence, and includes implications for treatment and prevention.
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Affiliation(s)
- Richard W Wilsnack
- Richard W. Wilsnack, Ph.D., is a professor emeritus in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Sharon C. Wilsnack, Ph.D., is the Chester Fritz Distinguished Professor in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Gerhard Gmel, Ph.D., is a professor, University of Lausanne, and is affiliated with the Alcohol Treatment Center, University of Lausanne Hospital, Lausanne, Switzerland. He is also an invited professor, University of the West of England, Bristol, United Kingdom. Lori Wolfgang Kantor, M.A., is a science writer at CSR, Incorporated
| | - Sharon C Wilsnack
- Richard W. Wilsnack, Ph.D., is a professor emeritus in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Sharon C. Wilsnack, Ph.D., is the Chester Fritz Distinguished Professor in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Gerhard Gmel, Ph.D., is a professor, University of Lausanne, and is affiliated with the Alcohol Treatment Center, University of Lausanne Hospital, Lausanne, Switzerland. He is also an invited professor, University of the West of England, Bristol, United Kingdom. Lori Wolfgang Kantor, M.A., is a science writer at CSR, Incorporated
| | - Gerhard Gmel
- Richard W. Wilsnack, Ph.D., is a professor emeritus in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Sharon C. Wilsnack, Ph.D., is the Chester Fritz Distinguished Professor in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Gerhard Gmel, Ph.D., is a professor, University of Lausanne, and is affiliated with the Alcohol Treatment Center, University of Lausanne Hospital, Lausanne, Switzerland. He is also an invited professor, University of the West of England, Bristol, United Kingdom. Lori Wolfgang Kantor, M.A., is a science writer at CSR, Incorporated
| | - Lori Wolfgang Kantor
- Richard W. Wilsnack, Ph.D., is a professor emeritus in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Sharon C. Wilsnack, Ph.D., is the Chester Fritz Distinguished Professor in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Gerhard Gmel, Ph.D., is a professor, University of Lausanne, and is affiliated with the Alcohol Treatment Center, University of Lausanne Hospital, Lausanne, Switzerland. He is also an invited professor, University of the West of England, Bristol, United Kingdom. Lori Wolfgang Kantor, M.A., is a science writer at CSR, Incorporated
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Hansen-Krone IJ, Brækkan SK, Enga KF, Wilsgaard T, Hansen JB. Alcohol consumption, types of alcoholic beverages and risk of venous thromboembolism – The Tromsø Study. Thromb Haemost 2017; 106:272-8. [DOI: 10.1160/th11-01-0043] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Accepted: 05/03/2011] [Indexed: 11/05/2022]
Abstract
SummaryModerate alcohol consumption has been shown to protect against cardiovascular diseases. The association between alcohol consumption, especially types of alcoholic beverages, and venous thromboembolism (VTE) is less well described. The aim of this study was to investigate the impact of alcohol consumption and different alcoholic beverages on risk of VTE. Information on alcohol consumption was collected by a selfadministrated questionnaire in 26,662 subjects, aged 25–97 years, who participated in the Tromsø Study, in 1994–1995. Subjects were followed through September 1, 2007 with incident VTE as the primary outcome. There were 460 incident VTE-events during a median of 12.5 years of follow-up. Total alcohol consumption was not associated with risk of incident VTE. However, subjects consuming ≥3 units of liquor per week had 53% increased risk of VTE compared to teetotalers in analyses adjusted for age, sex, body mass index, smoking, diabetes, cancer, previous cardiovascular disease, physical activity and higher education (HR: 1.53, 95% CI: 1.00–2.33). Contrary, subjects with a wine intake of ≥3 units/week had 22% reduced risk of VTE (HR: 0.78, 95% CI: 0.47–1.30), further adjustment for liquor and beer intake strengthened the protective effect of wine (HR: 0.53, 95% CI: 0.30–1.00). Frequent binge drinkers (≥1/week) had a 17% increased risk of VTE compared to teetotallers (HR 1.17, 95% CI: 0.66–2.09), and a 47% increased risk compared to non-binge drinkers (HR 1.47, 95% CI: 0.85–2.54). In conclusion, liquor consumption and binge drinking was associated with increased risk of VTE, whereas wine consumption was possibly associated with reduced risk of VTE.
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From psychological moments to mortality: A multidisciplinary synthesis on heart rate variability spanning the continuum of time. Neurosci Biobehav Rev 2017; 83:547-567. [PMID: 28888535 DOI: 10.1016/j.neubiorev.2017.09.006] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 09/04/2017] [Indexed: 02/05/2023]
Abstract
Heart rate variability (HRV) indexes functioning of the vagus nerve, arguably the most important nerve in the human body. The Neurovisceral Integration Model has provided a structural framework for understanding brain-body integration, highlighting the role of the vagus in adaptation to the environment. In the present paper, we emphasise a temporal framework in which HRV may be considered a missing, structural link between psychological moments and mortality, a proposal we label as Neurovisceral Integration Across a Continuum of Time (or NIACT). This new framework places neurovisceral integration on a dimension of time, highlighting implications for lifespan development and healthy aging, and helping to bridge the gap between clearly demarcated disciplines such as psychology and epidemiology. The NIACT provides a novel framework, which conceptualizes how everyday psychological moments both affect and are affected by the vagus in ways that have long-term effects on mortality risk. We further emphasize that a longitudinal approach to understanding change in vagal function over time may yield novel scientific insights and important public health outcomes.
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Chen J, Li JH, Zhao SJ, Wang DY, Zhang WZ, Liang WJ. Clinical significance of costimulatory molecules CD40/CD40L and CD134/CD134L in coronary heart disease: A case-control study. Medicine (Baltimore) 2017; 96:e7634. [PMID: 28796044 PMCID: PMC5556210 DOI: 10.1097/md.0000000000007634] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The aim of the study was to evaluate the potential role of CD40/CD40 ligand (CD40L) and CD134/CD134 ligand (CD134L) in the development of coronary heart disease (CHD) via the performance of a case-control study.The research objects were 234 cases of CHD patients and 120 cases of well-matched normal controls. Following the separation of peripheral blood mononuclear cells (PBMCs), real-time quantitative PCR (qRT-PCR), Western blot, immunohistochemistry, and flow cytometry were applied for the detection of mRNA levels and expression levels of CD40/CD40L and CD134/CD134L; meanwhile, intercellular adhesion molecule-1 (ICAM-1) and Fas protein mRNA levels were detected using qRT-PCR.There was no statistical difference in the comparison of baseline characteristics between groups, indicating comparability between groups. qRT-PCR and Western blot analysis indicated that CD40/CD40L and CD134/CD134L mRNA and protein expression levels were all increased in the CHD group than those in the control group. Flow cytometry further confirmed the similar tendency. Meanwhile, ICAM-1 and Fas protein mRNA levels were elevated in the CHD group and positively correlated with the above parameters. Furthermore, CD40/CD40L expression rates were negatively correlated with gender and different types of CHD. Meanwhile, CD134/CD134L expressions were also higher in male patients, in patients with family history, previous history of hypertension, diabetes, and cerebrovascular diseases.CD40/CD40L and CD134/CD134L are increased and may have potential correlation with clinical pathological features of patients with CHD. Further in-depth exploration of costimulatory molecules for CHD guidance as well as intrinsic mechanisms are needed combined with in vivo and in vitro experiments.
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Affiliation(s)
- Jun Chen
- Department of Cardiovascular Medicine, Guangzhou Panyu Central Hospital,
- Panyu District Cardiovascular Disease Research Institute of Guangzhou, Guangzhou, P.R. China
| | - Jian-Hao Li
- Department of Cardiovascular Medicine, Guangzhou Panyu Central Hospital,
- Panyu District Cardiovascular Disease Research Institute of Guangzhou, Guangzhou, P.R. China
| | - Shan-Jun Zhao
- Department of Cardiovascular Medicine, Guangzhou Panyu Central Hospital,
- Panyu District Cardiovascular Disease Research Institute of Guangzhou, Guangzhou, P.R. China
| | - Da-Yu Wang
- Department of Cardiovascular Medicine, Guangzhou Panyu Central Hospital,
- Panyu District Cardiovascular Disease Research Institute of Guangzhou, Guangzhou, P.R. China
| | - Wen-Zhu Zhang
- Department of Cardiovascular Medicine, Guangzhou Panyu Central Hospital,
- Panyu District Cardiovascular Disease Research Institute of Guangzhou, Guangzhou, P.R. China
| | - Wei-Jie Liang
- Department of Cardiovascular Medicine, Guangzhou Panyu Central Hospital,
- Panyu District Cardiovascular Disease Research Institute of Guangzhou, Guangzhou, P.R. China
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Katsarou MS, Karakonstantis K, Demertzis N, Vourakis E, Skarpathioti A, Nosyrev AE, Tsatsakis A, Kalogridis T, Drakoulis N. Effect of single-nucleotide polymorphisms in ADH1B, ADH4, ADH1C, OPRM1, DRD2, BDNF, and ALDH2 genes on alcohol dependence in a Caucasian population. Pharmacol Res Perspect 2017; 5. [PMID: 28805974 PMCID: PMC5684860 DOI: 10.1002/prp2.326] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 04/22/2017] [Indexed: 01/12/2023] Open
Abstract
Alcohol is a frequently used addictive substance worldwide. Aim of this study is to determine the frequency distribution of SNPs within ADH1B,ADH4,ADH1C,ALDH2, BDNF,OPRM1, and DRD2 genes in a southeastern European Caucasian population from Greece. For this purpose samples of 1276 volunteers were analyzed after deidentification and anonymization. The allele distribution of the examined polymorphisms in the present Greek population cohort was as follows: rs1229984 (ADH1B): GG(wt) = 64.14%, GA = 29.86%, AA = 4.00%; rs1693482 (ADH1C): CC(wt) = 57.45%, CT = 36.76%, TT = 5.80%; rs1799971 (OPRM1): AA(wt) = 72.43%, AG = 28.72%, GG = 1.89%; rs1800497 (DRD2): CC(wt) = 70.84%, CT = 27.18%, TT = 1.98%; rs1800759 (ADH4): CC(wt) = 34.25%, CA = 48.12%, AA = 17.63%; rs6265 (BDNF): GG(wt) = 65.99%, GA = 31.02%, AA = 2.99%; and rs671 (ALDH2): GG(wt) = 99.84% GA = 0.16%, AA = 0.00%. Mutant rs1229984 allele A was ~6.5× more frequent in the Greek than in the European population. Mutant rs1693482 allele T was ~1.7× more frequent in the European than in the Greek population. Mutant alleles for polymorphisms rs1800759 and rs1799971 show similar frequencies in both northern and southern Europeans. One rs671 mutant A allele was detected in the Greek population (0.08%). The mutant rs1800497 allele T was ~1.2× more frequent in the European than in the Greek population and the mutant rs6265 allele A was ~1.1× more frequent in the European than in the Greek population. An alcohol addiction‐specific algorithm was generated (TGS) that may predict alcohol addiction prevalence in a population. According to our findings, the analyzed Southeastern population may differ genetically from north Europeans due to influences from neighboring Asian and African populations and a calculated TGS score >50 indicates individuals with low susceptibility to develop alcohol addiction.
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Affiliation(s)
- Martha-Spyridoula Katsarou
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, 15771, Greece
| | - Konstantinos Karakonstantis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, 15771, Greece
| | - Nikolaos Demertzis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, 15771, Greece
| | - Emmanouil Vourakis
- Department of Biochemistry and Molecular Biology, Faculty of Biology, School of Health Sciences, National and Kapodistrian University of Athens, Athens, 15771, Greece
| | - Aspasia Skarpathioti
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, 15771, Greece
| | - Aleksandr E Nosyrev
- Central Chemical Laboratory of Toxicology, I. M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion, 71003, Greece
| | - Theodoris Kalogridis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, 15771, Greece
| | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, 15771, Greece
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Choi Y, Lee HJ. Do Regular Cholesterol Screenings Lead to Lower Cholesterol Levels and Better Health Behaviors for All? Spotlight on Middle-Aged and Older Adults in the United States. J Aging Health 2017; 29:389-414. [PMID: 26921271 DOI: 10.1177/0898264316635588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study investigates how the causal effects of cholesterol screening differ by likelihood of using this preventive care service in terms of accessibility gaps and effects on health-related outcomes across groups with advantaged and disadvantaged backgrounds. METHOD We use propensity score matching to analyze a nationally representative sample using data from 2008, 2010, and 2012 waves of the Health and Retirement Study ( N = 3,907). RESULTS We find that respondents who are least likely to get their cholesterol tested benefit most from the use of cholesterol screening when they do use it, while its effects are smallest for those who are most likely to use this service. DISCUSSION Understanding the heterogeneous effects of preventive health service has important policy implications, particularly in terms of how to maximize the public health benefits of preventive care.
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Affiliation(s)
- Yool Choi
- 1 University of California, Los Angeles, USA
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Kalla A, Figueredo VM. Alcohol and cardiovascular disease in the geriatric population. Clin Cardiol 2017; 40:444-449. [PMID: 28294372 DOI: 10.1002/clc.22681] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 01/06/2017] [Accepted: 01/11/2017] [Indexed: 01/19/2023] Open
Abstract
There has been little focus on the effects of alcohol on the elderly. Although the cardiovascular benefits of moderate alcohol consumption could be of the greatest benefit in this group, so might be the detrimental effects of abuse. In this article, we review available data on the effects of alcohol consumption on cardiovascular disease, cardiomyopathy, arrhythmias, hypertension, and vascular function in older adults. Alcohol consumption has increased in the US population age 65 years and older in the last decade, as has monthly heavy episodic drinking in older alcohol consumers. Studies of alcohol consumption in older subjects suggest that consumption in moderation does not increase the risk of heart failure, hypertension, or atrial arrhythmias, and may in fact improve vascular function and reduce cardiovascular disease events. As in younger subjects, heavy consumption, or abuse of alcohol, negates any potential protective cardiovascular effects, increasing the incidence of heart failure and hypertension. Although alcohol consumed in moderation does not appear harmful in the elderly population, heavier consumption exacerbates hypertension and increases the incidence of heart failure.
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Affiliation(s)
- Aditi Kalla
- Institute for Heart & Vascular Health, Division of Cardiology, Einstein Medical Center, Philadelphia, Pennsylvania
| | - Vincent M Figueredo
- Institute for Heart & Vascular Health, Division of Cardiology, Einstein Medical Center, Philadelphia, Pennsylvania.,Sidney Kimmel College of Medicine at Thomas Jefferson University, Philadelphia, Pennsylvania
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Adherence to a healthy Nordic food index and risk of myocardial infarction in middle-aged Danes: the diet, cancer and health cohort study. Eur J Clin Nutr 2017; 71:652-658. [PMID: 28247857 DOI: 10.1038/ejcn.2017.1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 09/25/2016] [Accepted: 12/28/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes. SUBJECTS/METHODS Data were obtained from the Danish Diet, Cancer and Health cohort study of 57 053 men and women aged 50-64 years recruited between 1993 and 1997. The healthy Nordic food index comprised healthy Nordic food items selected a priori (fish, cabbage, rye bread, oatmeal, apple and pears and root vegetables). Information on incident MI was ascertained through linkage with national registries. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated from sex-specific Cox proportional hazard models. RESULTS In total, 1669 men and 653 women developed MI during follow-up (13.6 median years). In adjusted models, those with an index score of 5-6 points (highest scores) had significantly lower MI risk (men: HR=0.77, 95% CI=0.62, 0.97; women: HR=0.55, 95% CI=0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR=0.95, 95% CI=0.92, 0.99) and women (HR=0.93, 95% CI=0.88, 0.98). CONCLUSIONS A healthy Nordic diet is associated with lower MI risk among middle-aged Danes, suggesting that Nordic diets should be considered in recommendations for dietary changes in the promotion of coronary health.
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Scoccianti C, Cecchini M, Anderson AS, Berrino F, Boutron-Ruault MC, Espina C, Key TJ, Leitzmann M, Norat T, Powers H, Wiseman M, Romieu I. European Code against Cancer 4th Edition: Alcohol drinking and cancer. Cancer Epidemiol 2016; 45:181-188. [PMID: 27816465 DOI: 10.1016/j.canep.2016.09.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Alcohol consumption is the third leading risk factor for disease and mortality in Europe. As evaluated by the International Agency for Research on Cancer (IARC) Monographs, a causal relationship is established for consumption of alcoholic beverages and cancers of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum and female breast, even at low and moderate alcohol intakes. The higher the amount of alcohol consumed, the higher the risk of developing cancer. In Europe, an estimated 10% (95% CI: 7%-13%) of all cancer cases in men and 3% (95% CI: 1%-5%) of all cancer cases in women are attributable to alcohol consumption. Several biological mechanisms explain the carcinogenicity of alcohol; among them, ethanol and its genotoxic metabolite, acetaldehyde, play a major role. Taking all this evidence into account, a recommendation of the 4th edition of European Code against Cancer is: "If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention."
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Affiliation(s)
- Chiara Scoccianti
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Michele Cecchini
- Health Policy Analyst OECD, 2 rue André Pascal, 75775 Paris Cedex 16, France
| | - Annie S Anderson
- Centre for Research into Cancer Prevention & Screening, Level 7, Mailbox 7, Ninewells Hospital & Medical School, Dundee, DD1 9SY, Scotland, United Kingdom
| | - Franco Berrino
- Fondazione IRCSS Istituto Nazionale dei Tumori, 1 via Venezian, 20133 Milan, Italy
| | | | - Carolina Espina
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, 93042 Regensburg, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom
| | - Hilary Powers
- Human Nutrition Unit, The Medical School, Beech Hill Road, Sheffield S10 2RX, United Kingdom
| | - Martin Wiseman
- World Cancer Research Fund International, Second Floor, 22 Bedford Square, London WC1 B 3HH, United Kingdom
| | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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Vidot DC, Stoutenberg M, Gellman M, Arheart KL, Teng Y, Daviglus ML, González HM, Talavera G, Isasi CR, Heiss G, Schneiderman N. Alcohol Consumption and Metabolic Syndrome Among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos. Metab Syndr Relat Disord 2016; 14:354-62. [PMID: 27304318 PMCID: PMC5011615 DOI: 10.1089/met.2015.0171] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The association between alcohol consumption and metabolic syndrome (MetS) among Hispanic/Latino populations has not been studied in great detail. Our study examined the relationship between alcohol consumption and MetS among U.S. Hispanics/Latinos and explored whether this relationship varied by age, body mass index, gender, and Hispanic/Latino backgrounds. METHODS The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a multisite, prospective, population-based, cohort study of Hispanics/Latinos, ages 18-74 years from four U.S. communities. Participants were categorized into never, former, occasional, low, moderate, and high alcohol consumption categories. A cross-sectional analysis of 15,905 participants with complete data was conducted. Survey design appropriate chi-squared and logistic regression models were run to detect significant associations between alcohol consumption categories and cases of MetS. RESULTS Almost half (47.4%) of the sample was classified as occasional, low, moderate, or heavy drinkers. Low and moderate alcohol consumers had lower odds of MetS than never drinkers. Low and heavy drinkers had higher odds of presenting with elevated central obesity, while occasional, low, moderate, and heavy drinkers had higher odds of having low high-density lipoprotein cholesterol levels compared to never drinkers. Low and moderate wine drinkers had lower odds of MetS compared to never drinkers. There were no significant findings among beer or liquor drinkers, or with binge drinking after model adjustments. CONCLUSIONS Our findings suggest that low and moderate alcohol consumption may lower the odds of MetS in a sample of Hispanic/Latino adults, but that the relationship of alcohol consumption varies with the individual components of MetS.
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Affiliation(s)
- Denise C. Vidot
- Department of Psychology and Behavioral Medicine Research Center, University of Miami, Coral Gables, Florida
| | - Mark Stoutenberg
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Marc Gellman
- Department of Psychology and Behavioral Medicine Research Center, University of Miami, Coral Gables, Florida
| | - Kristopher L. Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Yanping Teng
- Department of Biostatistics, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois
| | - Hector M. González
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan
| | - Gregory Talavera
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Neil Schneiderman
- Department of Psychology and Behavioral Medicine Research Center, University of Miami, Coral Gables, Florida
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Yedlapati SH, Mendu A, Stewart SH. Alcohol-related diagnoses and increased mortality in acute myocardial infarction patients: An analysis of the nationwide inpatient sample. J Hosp Med 2016; 11:563-7. [PMID: 27043326 DOI: 10.1002/jhm.2584] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 02/01/2016] [Accepted: 02/28/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Moderate alcohol consumption has been associated with lower risk of coronary heart disease death, but heavy alcohol consumption may increase risk. OBJECTIVE We sought to determine the association of alcohol-related diagnoses with in-hospital mortality in patients with acute myocardial infarction (AMI). DESIGN/SETTING/PATIENTS Discharge data collected from all admissions recorded in the Nationwide Inpatient Sample (NIS) database from 2011. A cross-sectional analysis was performed using regression methods appropriate for the NIS sample design. MEASURES The outcome measures were in-hospital mortality, length of stay, and cardiac procedures. RESULTS AMI accounted for 610,963 (1.9%) of adult in-patient admissions, with an in-hospital mortality rate of 5.3%. Alcohol-related diagnoses were associated with increased mortality in AMI patients after controlling for factors associated with alcoholism including age, sex, liver disease, hypertension, diabetes, renal failure, peripheral vascular disease, arrhythmias, drug abuse, gastrointestinal bleed, and smoking (adjusted odds ratio [OR]: 1.5, 95% confidence interval [CI]: 1.2-1.7, P < 0.001). This association was significant in both ST-elevation myocardial infarction patients (adjusted OR: 1.7, 95% CI: 1.4-2.2, P < 0.001) and non-ST-elevation myocardial infarction patients (adjusted OR: 1.3, 95% CI: 1.0-1.7, P = 0.025). Chronic alcohol-related diagnoses were significantly associated with death, but acute alcohol effects (as estimated by withdrawal and intoxication) were not associated. CONCLUSION Chronic alcohol-related diagnoses were associated with a modest increase in the risk for death in individuals presenting with AMI. This risk was not accounted for by common alcohol-related comorbidities. As a component of global efforts to limit hospital deaths from AMI, future research should identify the factors underlying this association. Journal of Hospital Medicine 2016;11:563-567. © 2016 Society of Hospital Medicine.
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Affiliation(s)
- Siva Harsha Yedlapati
- Division of General Internal Medicine, University at Buffalo, State University of New York, Buffalo, New York
| | - Anuradha Mendu
- Division of General Internal Medicine, University at Buffalo, State University of New York, Buffalo, New York
| | - Scott H Stewart
- Division of General Internal Medicine, University at Buffalo, State University of New York, Buffalo, New York
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Song CL, Diao HY, Wang JH, Shi YF, Lu Y, Wang G, Guo ZY, Li YX, Liu JG, Wang JP, Zhang JC, Zhao Z, Liu YH, Li Y, Cai D, Li Q. Diagnostic Value of Serum YKL-40 Level for Coronary Artery Disease: A Meta-Analysis. J Clin Lab Anal 2016; 30:23-31. [PMID: 27152377 DOI: 10.1002/jcla.21804] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE This meta-analysis aimed to identify the value of serum YKL-40 level for the diagnosis of coronary artery disease (CAD). METHODS Through searching the following electronic databases: the Cochrane Library Database (Issue 12, 2013), Web of Science (1945 ∼ 2013), PubMed (1966 ∼ 2013), CINAHL (1982 ∼ 2013), EMBASE (1980 ∼ 2013), and the Chinese Biomedical Database (CBM; 1982 ∼ 2013), related articles were determined without any language restrictions. STATA statistical software (Version 12.0, Stata Corporation, College Station, TX) was chosen to deal with statistical data. Standard mean difference (SMD) and its corresponding 95% confidence interval (95% CI) were calculated. RESULTS Eleven clinical case-control studies that recruited 1,175 CAD patients and 1,261 healthy controls were selected for statistical analysis. The main findings of our meta-analysis showed that serum YKL-40 level in CAD patients was significantly higher than that in control subjects (SMD = 2.79, 95% CI = 1.73 ∼ 3.85, P < 0.001). Ethnicity-stratified analysis indicated a higher serum YKL-40 level in CAD patients than control subjects among China, Korea, and Denmark populations (China: SMD = 2.97, 95% CI = 1.21 ∼ 4.74, P = 0.001; Korea: SMD = 0.66, 95% CI = 0.17 ∼ 1.15, P = 0.008; Denmark: SMD = 1.85, 95% CI = 1.42 ∼ 2.29, P < 0.001; respectively), but not in Turkey (SMD = 4.52, 95% CI = -2.87 ∼ 11.91, P = 0.231). CONCLUSION The present meta-analysis suggests that an elevated serum YKL-40 level may be used as a promising diagnostic tool for early identification of CAD.
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Ogeil RP, Gao CX, Rehm J, Gmel G, Lloyd B. Temporal changes in alcohol-related mortality and morbidity in Australia. Addiction 2016; 111:626-34. [PMID: 26498429 DOI: 10.1111/add.13213] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 07/24/2015] [Accepted: 10/18/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS Alcohol consumption is an avoidable risk factor for morbidity and mortality. Studies have examined relative risks and outcomes of alcohol-related harms in Australia at discrete times, limiting the ability to examine changes across time. This paper examined alcohol consumption and its contribution to deaths, illness and injury at two time-points, 2001 and 2010. DESIGN Alcohol consumption was modelled based on the 2001 and 2010 National Drug Strategy Household Survey, upshifted to reflect alcohol sales data. SETTING All data reported are from Australian sources. MEASUREMENTS Based on relative risk estimates obtained from meta-analysis, alcohol-attributable fractions were estimated for 42 disease and injury categories in 2001 and 2010 separately for conditions that were not 100% alcohol-attributable. Deaths and hospital separations attributable to alcohol were calculated in 2001 and 2010. FINDINGS There was a relatively stable per capita consumption of alcohol across time, with males reporting higher levels of consumption compared with females. While there were increases in the number of abstainers from alcohol across time, the proportion of heavy alcohol consumers also increased. This corresponded with an observed increase in alcohol-attributable burden. For example, alcohol-attributable deaths increased from 4957 [95% confidence interval (CI) = 2867-8770] to 5610 (95% CI = 3398-9408) during the study period. CONCLUSION The findings demonstrate that there has been an increase in alcohol-attributable harms between 2001 and 2010 in Australia without a corresponding increase in per capita consumption.
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Affiliation(s)
- Rowan P Ogeil
- Eastern Health Clinical School, Monash University, Fitzroy, Victoria, Australia.,Turning Point, Eastern Health, Fitzroy, Victoria, Australia
| | - Caroline X Gao
- Eastern Health Clinical School, Monash University, Fitzroy, Victoria, Australia.,Turning Point, Eastern Health, Fitzroy, Victoria, Australia
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada.,Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - Gerrit Gmel
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, Australia.,Implant Systems Group, National Information and Communications Technology Australia, Sydney, Australia
| | - Belinda Lloyd
- Eastern Health Clinical School, Monash University, Fitzroy, Victoria, Australia.,Turning Point, Eastern Health, Fitzroy, Victoria, Australia
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Silva EC, Martins MSAS, Guimarães LV, Segri NJ, Lopes MAL, Espinosa MM. Prevalência de hipertensão arterial sistêmica e fatores associados em homens e mulheres residentes em municípios da Amazônia Legal. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2016; 19:38-51. [PMID: 27167647 DOI: 10.1590/1980-5497201600010004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 12/11/2015] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Introdução: A hipertensão arterial sistêmica é um importante problema de saúde pública devido à sua alta prevalência, baixas taxas de controle e causa de morbidade e mortalidade cardiovascular. Objetivo: Analisar a prevalência de hipertensão arterial sistêmica e fatores associados em homens e mulheres residentes em municípios da Amazônia Legal. Métodos: No estudo transversal de base populacional conduzido com 1.296 adultos de ambos os sexos foram coletados dados sociodemográficos, estilo de vida, antropométricos e pressão arterial, sendo considerados hipertensos os que apresentaram pressão arterial ≥ 140/90 mmHg e/ou os que referiram uso de drogas anti-hipertensivas. As análises estatísticas foram feitas no módulo survey do programa Stata versão 11.0. Resultados: A prevalência da hipertensão arterial sistêmica foi de 22,3%. Após ajustes, as variáveis que se associaram à hipertensão nos homens foram a idade de 30 a 39 anos (RP ajustada = 2,69; IC95% 1,49 - 4,86), 40 a 49 anos (RP ajustada = 3,28; IC95% 1,82 - 5,93) e 50 a 59 anos (RP ajustada = 4,80; IC95% 2,63 - 8,76), sobrepeso (RP ajustada = 1,97; IC95% 1,39 - 2,78), obesidade (RP ajustada = 3,32; IC95% 2,32 - 4,75) e ser natural da região Norte ou Nordeste (RP ajustada = 0,31; IC95% 0,18 - 0,59). Entre as mulheres, associaram à hipertensão a idade de 40 a 49 anos (RP ajustada = 3,41; IC95% 1,91 - 6,07) e 50 a 59 anos (RP ajustada = 7,29; IC95% 4,07 - 13,07); o consumo de vinho (RP ajustada = 0,31; IC95% 0,10 - 0,97) e obesidade (RP ajustada = 2,39; IC95% 1,65 - 3,45). Conclusão: A hipertensão arterial associou-se independentemente com a idade, estado nutricional e naturalidade nos homens. E nas mulheres com a idade, estado nutricional e tipo de bebida alcoólica.
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Choi NG, DiNitto DM, Marti CN, Choi BY. Sociodemographic Characteristics and Health Status of Lifetime Abstainers, Ex-Drinkers, Bingers, and Nonbingers Among Baby Boomers and Older Adults. Subst Use Misuse 2016; 51:637-48. [PMID: 27007029 DOI: 10.3109/10826084.2015.1133645] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Health risks associated with abstention from alcohol drinking in previous studies may have been exaggerated because the pool of abstainers in many studies included both lifetime abstainers and ex-drinkers, including sick-quitters. OBJECTIVES This study compared sociodemographic and health statuses among lifetime abstainers, exdrinkers, bingers, and nonbingers in the 50-64 age group (baby boomers) and the 65+ age group. METHODS Data are from the 2008 to 2012 National Survey on Drug Use and Health (N = 18,443 for the 50-64 age group and N = 11,191 for the 65+ age group). Descriptive statistics and multinomial and binary logistic regression analyses were used to examine the study questions. RESULTS 10% of the 50-64 age group and 20% of the 65+ age group reported lifetime abstention, and 21% and 28% of each group, respectively, reported being ex-drinkers (i.e., last used alcohol more than 12 months ago). In both age groups, lifetime abstainers, exdrinkers, and bingers had lower socioeconomic status than nonbingers. In the 50-64 age group, lifetime abstainers did not differ from or were less likely than nonbingers to have vascular and hepatic/gastrointestinal (HGI) disorders, but exdrinkers were more likely to have these diseases, and both lifetime abstainers and exdrinkers were more likely to have diabetes. In the 65+ age group, lifetime abstainers did not differ from nonbingers on high blood pressure, heart disease, and HGI, but both they and the exdrinkers were more likely to have stroke and diabetes. CONCLUSIONS/IMPORTANCE Diabetes screening/monitoring and stroke prevention/care are recommended for both age groups of abstainers and exdrinkers.
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Affiliation(s)
- Namkee G Choi
- a School of Social Work, University of Texas at Austin , Austin , Texas , USA
| | - Diana M DiNitto
- a School of Social Work, University of Texas at Austin , Austin , Texas , USA
| | - C Nathan Marti
- a School of Social Work, University of Texas at Austin , Austin , Texas , USA
| | - Bryan Y Choi
- b Department of Emergency Medicine , Warren Alpert Medical School, Brown University , Providence , Rhode Island , USA
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Moriconi PA, Nadeau L. A Cross-Sectional Study of Self-Rated Health among Older Adults: Association with Drinking Profiles and Other Determinants of Health. Curr Gerontol Geriatr Res 2015; 2015:352947. [PMID: 26843861 PMCID: PMC4710937 DOI: 10.1155/2015/352947] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 12/09/2015] [Indexed: 01/01/2023] Open
Abstract
This study compares the relationship between drinking profiles and self-rated health with and without adjusting for other determinants of health among a sample of older adults from the general population. Respondents were 1,494 men and 2,176 women aged between 55 and 74 from the GENACIS Canadian survey. The dependent variable was self-rated health, an individual's perception of his or her own general health, a measure used as a proxy for health status. The independent variables were drinking profiles (types of drinkers and nondrinkers) as well as other demographic, psychosocial, and health-related variables (control variables). After adjustment for other determinants of health, regression analyses showed that (1) frequent/moderate drinkers were more likely to have a better self-rated health compared with nondrinkers (lifetime abstainers and former drinkers) and (2) self-rated health did not differ significantly between frequent/moderate drinkers and other types of drinkers (frequent/nonmoderate and infrequent drinkers). Our results suggest that drinking is related to a better self-rated health compared with nondrinking regardless of the drinking profile. Drinking and healthy lifestyle guidelines specific to older adults should be studied, discussed, and integrated into public health practices.
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Affiliation(s)
- Pascale Audrey Moriconi
- Department of Psychology, Université de Montréal, CP 6128, Succursale Centre-Ville, Montréal, QC, Canada H3C 3J7
| | - Louise Nadeau
- Department of Psychology, Université de Montréal, CP 6128, Succursale Centre-Ville, Montréal, QC, Canada H3C 3J7
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Scoccianti C, Cecchini M, Anderson AS, Berrino F, Boutron-Ruault MC, Espina C, Key TJ, Leitzmann M, Norat T, Powers H, Wiseman M, Romieu I. European Code against Cancer 4th Edition: Alcohol drinking and cancer. Cancer Epidemiol 2015; 39 Suppl 1:S67-74. [PMID: 26115567 DOI: 10.1016/j.canep.2015.01.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 11/10/2014] [Accepted: 01/16/2015] [Indexed: 12/16/2022]
Abstract
Alcohol consumption is the third leading risk factor for disease and mortality in Europe. The International Agency for Research on Cancer (IARC) Monographs provide strengthened evidence that the consumption of alcoholic beverages is causally associated with cancers of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum and female breast, even for low and moderate alcohol intakes. The risk of cancer increases in a dose-dependent manner, and the higher the amount of alcohol consumed, the higher the risk of developing cancer. Several biological mechanisms explain the carcinogenicity of alcohol; among them, ethanol and its genotoxic metabolite acetaldehyde play a major role. Taking all this evidence into account, a recommendation of the 4th edition of the European Code against Cancer (ECAC) is: "If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention."
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Affiliation(s)
- Chiara Scoccianti
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Michele Cecchini
- Health Policy Analyst OECD, 2 rue André Pascal, 75775 Paris Cedex 16, France
| | - Annie S Anderson
- Centre for Research into Cancer Prevention & Screening, Level 7, Mailbox 7, Ninewells Hospital & Medical School, Dundee, DD1 9SY, Scotland, United Kingdom
| | - Franco Berrino
- Fondazione IRCSS Istituto Nazionale dei Tumori, 1 via Venezian, 20133 Milan, Italy
| | | | - Carolina Espina
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, 93042 Regensburg, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health Imperial College London, St Mary's Campus, London W2 1 PG, United Kingdom
| | - Hilary Powers
- Human Nutrition Unit, The Medical School, Beech Hill Road, Sheffield, S10 2RX, United Kingdom
| | - Martin Wiseman
- World Cancer Research Fund International, Second Floor, 22 Bedford Square, London WC1B 3HH, United Kingdom
| | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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Liu Y, Nguyen N, Colditz GA. Links between alcohol consumption and breast cancer: a look at the evidence. ACTA ACUST UNITED AC 2015; 11:65-77. [PMID: 25581056 DOI: 10.2217/whe.14.62] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Alcohol consumption by adult women is consistently associated with risk of breast cancer. Several questions regarding alcohol and breast cancer need to be addressed. Menarche to first pregnancy represents a window of time when breast tissue is particularly susceptible to carcinogens. Youth alcohol consumption is common in the USA, largely in the form of binge drinking and heavy drinking. Whether alcohol intake acts early in the process of breast tumorigenesis is unclear. This review aims to focus on the influences of timing and patterns of alcohol consumption and the effect of alcohol on intermediate risk markers. We also review possible mechanisms underlying the alcohol-breast cancer association.
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Affiliation(s)
- Ying Liu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
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Helm L, Macdonald IA. Impact of beverage intake on metabolic and cardiovascular health. Nutr Rev 2015; 73 Suppl 2:120-9. [DOI: 10.1093/nutrit/nuv049] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Zhang XY, Shu L, Si CJ, Yu XL, Liao D, Gao W, Zhang L, Zheng PF. Dietary Patterns, Alcohol Consumption and Risk of Coronary Heart Disease in Adults: A Meta-Analysis. Nutrients 2015; 7:6582-605. [PMID: 26262641 PMCID: PMC4555139 DOI: 10.3390/nu7085300] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 07/22/2015] [Accepted: 07/24/2015] [Indexed: 12/14/2022] Open
Abstract
Previous studies reported the potential associations between dietary patterns and the risk of coronary heart disease (CHD) in adulthood, however a consistent perspective has not been established to date. Herein, we carried out this meta-analysis to evaluate the associations between dietary patterns and the risk of CHD. MEDLINE and EBSCO were searched for relevant articles published up to April 2015. A total of 35 articles (reporting 37 original studies) met the inclusion criteria and were included in the present meta-analysis. The decreased risk of CHD was shown for the highest compared with the lowest categories of healthy/prudent dietary patterns (odds ratio (OR) = 0.67; 95% confidence interval (CI): 0.60, 0.75; p < 0.00001) and alcohol consumption (OR = 0.68; 95% CI: 0.59, 0.78; p < 0.00001). There was evidence of an increased risk of CHD in the highest compared with the lowest categories of the unhealthy/Western-type dietary patterns (OR = 1.45; 95% CI: 1.05, 2.01; p = 0.02). The results of this meta-analysis indicate that different dietary patterns may be associated with the risk of CHD.
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Affiliation(s)
- Xiao-Yan Zhang
- Department of Nutrition, Zhejiang Hospital, Hangzhou 310013, China.
| | - Long Shu
- Department of Nutrition, Zhejiang Hospital, Hangzhou 310013, China.
| | - Cai-Juan Si
- Department of Nutrition, Zhejiang Hospital, Hangzhou 310013, China.
| | - Xiao-Long Yu
- Department of Nutrition, Zhejiang Hospital, Hangzhou 310013, China.
| | - Dan Liao
- Department of Nutrition, Zhejiang Hospital, Hangzhou 310013, China.
| | - Wei Gao
- Department of Nutrition, Zhejiang Hospital, Hangzhou 310013, China.
| | - Lun Zhang
- Department of Nutrition, Zhejiang Hospital, Hangzhou 310013, China.
| | - Pei-Fen Zheng
- Department of Nutrition, Zhejiang Hospital, Hangzhou 310013, China.
- Department of Digestion, Zhejiang Hospital, Hangzhou 310013, China.
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46
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Dai J, Mukamal KJ, Krasnow RE, Swan GE, Reed T. Higher usual alcohol consumption was associated with a lower 41-y mortality risk from coronary artery disease in men independent of genetic and common environmental factors: the prospective NHLBI Twin Study. Am J Clin Nutr 2015; 102:31-9. [PMID: 25948664 PMCID: PMC4480668 DOI: 10.3945/ajcn.114.106435] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 03/27/2015] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Evidence that alcohol consumption is inversely associated with long-term coronary artery disease (CAD) mortality independent of genetic and early life environmental factors is lacking. OBJECTIVE We evaluated whether alcohol consumption was prospectively associated with CAD mortality risk independent of familial factors. DESIGN In total, 843 male twins (396 pairs and 51 unpaired twins) aged 42-55 y (mean: 48 y) without baseline CAD reported beer, wine, and spirits consumption at baseline (1969-1973) and were followed up to 2010 in the prospective National Heart, Lung, and Blood Institute Twin Study. Data on usual alcohol consumption over the past year were collected. Outcome was time to event, where the primary event was death from CAD and secondary events were death from cardiovascular disease and all causes. HRs were estimated by using frailty survival models, both overall and within-pair. RESULTS There were 129 CAD deaths and 219 cardiovascular deaths during 41 y of follow-up. In the whole cohort, after adjustment for caloric intake and cardiovascular disease risk factors, overall HRs per 10-g increment in alcohol intake were 0.94 (95% CI: 0.89, 0.98) for CAD and 0.97 (95% CI: 0.93, 1.00) for cardiovascular mortality. The within-pair adjusted HRs for a twin with 10-g higher daily alcohol consumption than his co-twin were 0.90 (95% CI: 0.84, 0.97) for CAD and 0.95 (95% CI: 0.90, 1.00) for cardiovascular disease mortality in the cohort pooled by zygosity, which remained similar among monozygotic twins. All 3 beverage types tended to be associated with lower CAD mortality risk within-pair to a similar degree. Alcohol consumption was not associated with total mortality risk overall or within-pair. CONCLUSION Higher usual alcohol consumption is associated with lower CAD mortality risk, independent of germline and early life environment and adulthood experience shared among twins, supporting a possible causal role of alcohol consumption in lowering CAD death risk. This trial was registered at clinicaltrials.gov as NCT00005124.
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Affiliation(s)
- Jun Dai
- Division of Epidemiology, Department of Medicine, Vanderbilt Center for Translational and Clinical Cardiovascular Research, Vanderbilt University Medical Center, Nashville, Tennessee;
| | - Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Ruth E Krasnow
- Center for Health Sciences, Biosciences Division, SRI International, Menlo Park, CA
| | - Gary E Swan
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA; and
| | - Terry Reed
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
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Abstract
The heart and vascular system are susceptible to the harmful effects of alcohol. Alcohol is an active toxin that undergoes widespread diffusion throughout the body, causing multiple synchronous and synergistic effects. Alcohol consumption decreases myocardial contractility and induces arrhythmias and dilated cardiomyopathy, resulting in progressive cardiovascular dysfunction and structural damage. Alcohol, whether at binge doses or a high cumulative lifetime consumption-both of which should be discouraged-is clearly deleterious for the cardiovascular system, increasing the incidence of total and cardiovascular mortality, coronary and peripheral artery disease, heart failure, stroke, hypertension, dyslipidaemia, and diabetes mellitus. However, epidemiological, case-control studies and meta-analyses have shown a U-type bimodal relationship so that low-to-moderate alcohol consumption (particularly of wine or beer) is associated with a decrease in cardiovascular events and mortality, compared with abstention. Potential confounding influences-alcohol-dose quantification, tobacco use, diet, exercise, lifestyle, cancer risk, accidents, and dependence-can affect the results of studies of both low-dose and high-dose alcohol consumption. Mendelian methodological approaches have led to doubts regarding the beneficial cardiovascular effects of alcohol, and the overall balance of beneficial and detrimental effects should be considered when making individual and population-wide recommendations, as reductions in alcohol consumption should provide overall health benefits.
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Hoffman LA, Sklar AL, Nixon SJ. The effects of acute alcohol on psychomotor, set-shifting, and working memory performance in older men and women. Alcohol 2015; 49:185-91. [PMID: 25920000 PMCID: PMC4413013 DOI: 10.1016/j.alcohol.2015.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 09/02/2014] [Accepted: 02/23/2015] [Indexed: 10/23/2022]
Abstract
A limited number of publications have documented the effects of acute alcohol administration among older adults. Among these, only a few have investigated sex differences within this population. The current project examined the behavioral effects of acute low- and moderate-dose alcohol on 62 older (ages 55-70) male and female, healthy, light to moderate drinkers. Participants were randomly assigned to one of three dose conditions: placebo (peak breath alcohol concentration [BrAC] of 0 mg/dL), low (peak BrAC of 40 mg/dL), and moderate (peak BrAC of 65 mg/dL). Tasks assessed psychomotor, set-shifting, and working memory performance. Better set-shifting abilities were observed among women, whereas men demonstrated more efficient working memory, regardless of dose. The moderate-dose group did not significantly differ from the placebo group on any task. However, the low-dose group performed better than the moderate-dose group across measures of set shifting and working memory. Relative to the placebo group, the low-dose group exhibited better working memory, specifically for faces. Interestingly, there were no sex by dose interactions. These data suggest that, at least for our study's task demands, low and moderate doses of alcohol do not significantly hinder psychomotor, set-shifting, or working memory performance among older adults. In fact, low-dose alcohol may facilitate certain cognitive abilities. Furthermore, although sex differences in cognitive abilities were observed, these alcohol doses did not differentially affect men and women. Further investigation is necessary to better characterize the effects of sex and alcohol dose on cognition in older adults.
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Affiliation(s)
- Lauren A Hoffman
- University of Florida, Department of Psychiatry, P.O. Box 100256, Gainesville, FL 32610-0256, USA.
| | - Alfredo L Sklar
- University of Florida, Department of Psychiatry, P.O. Box 100256, Gainesville, FL 32610-0256, USA
| | - Sara Jo Nixon
- University of Florida, Department of Psychiatry, P.O. Box 100256, Gainesville, FL 32610-0256, USA
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Dorans KS, Mostofsky E, Levitan EB, Håkansson N, Wolk A, Mittleman MA. Alcohol and incident heart failure among middle-aged and elderly men: cohort of Swedish men. Circ Heart Fail 2015; 8:422-7. [PMID: 25872788 DOI: 10.1161/circheartfailure.114.001787] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 04/07/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Compared with no alcohol consumption, heavy alcohol intake is associated with a higher rate of heart failure (HF) whereas light-to-moderate intake may be associated with a lower rate. However, several prior studies did not exclude former drinkers, who may have changed alcohol consumption in response to diagnosis. This study aimed to investigate the association between alcohol intake and incident HF. METHODS AND RESULTS We conducted a prospective cohort study of 33 760 men aged 45 to 79 years with no HF, diabetes mellitus, or myocardial infarction at baseline participating in the Cohort of Swedish Men Study. We excluded former drinkers. At baseline, participants completed a food frequency questionnaire and reported other characteristics. HF was defined as hospitalization for or death from HF, ascertained by Swedish inpatient and cause-of-death records from January 1, 1998, through December 31, 2011. We constructed Cox proportional hazards models to estimate multivariable-adjusted incidence rate ratios. During follow-up, 2916 men were hospitalized for (n=2139) or died (n=777) of incident HF. There was a U-shaped relationship between total alcohol intake and incident HF (P=0.0004). There was a nadir at light-to-moderate alcohol intake: consuming 7 to <14 standard drinks per week was associated with a 19% lower multivariable-adjusted rate of HF compared with never drinking (incidence rate ratio, 0.81; 95% confidence interval, 0.69-0.96). CONCLUSIONS In this cohort of Swedish men, there was a U-shaped relationship between alcohol consumption and HF incidence, with a nadir at light-to-moderate intake. Heavy intake did not seem protective.
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Affiliation(s)
- Kirsten S Dorans
- From the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (K.S.D., E.M., M.A.M.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (K.S.D., E.M., M.A.M.); Department of Epidemiology, University of Alabama at Birmingham (E.B.L.); and Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (N.H., A.W.)
| | - Elizabeth Mostofsky
- From the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (K.S.D., E.M., M.A.M.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (K.S.D., E.M., M.A.M.); Department of Epidemiology, University of Alabama at Birmingham (E.B.L.); and Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (N.H., A.W.)
| | - Emily B Levitan
- From the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (K.S.D., E.M., M.A.M.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (K.S.D., E.M., M.A.M.); Department of Epidemiology, University of Alabama at Birmingham (E.B.L.); and Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (N.H., A.W.)
| | - Niclas Håkansson
- From the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (K.S.D., E.M., M.A.M.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (K.S.D., E.M., M.A.M.); Department of Epidemiology, University of Alabama at Birmingham (E.B.L.); and Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (N.H., A.W.)
| | - Alicja Wolk
- From the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (K.S.D., E.M., M.A.M.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (K.S.D., E.M., M.A.M.); Department of Epidemiology, University of Alabama at Birmingham (E.B.L.); and Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (N.H., A.W.)
| | - Murray A Mittleman
- From the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (K.S.D., E.M., M.A.M.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (K.S.D., E.M., M.A.M.); Department of Epidemiology, University of Alabama at Birmingham (E.B.L.); and Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (N.H., A.W.).
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Mathews MJ, Liebenberg L, Mathews EH. The mechanism by which moderate alcohol consumption influences coronary heart disease. Nutr J 2015; 14:33. [PMID: 25889723 PMCID: PMC4389579 DOI: 10.1186/s12937-015-0011-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 02/13/2015] [Indexed: 02/06/2023] Open
Abstract
Background Moderate alcohol consumption is associated with a lower risk for coronary heart disease (CHD). A suitably integrated view of the CHD pathogenesis pathway will help to elucidate how moderate alcohol consumption could reduce CHD risk. Methods A comprehensive literature review was conducted focusing on the pathogenesis of CHD. Biomarker data were further systematically analysed from 294 cohort studies, comprising 1 161 560 subjects. From the above a suitably integrated CHD pathogenetic system for the purpose of this study was developed. Results The resulting integrated system now provides insight into the integrated higher-order interactions underlying CHD and moderate alcohol consumption. A novel ‘connection graph’ further simplifies these interactions by illustrating the relationship between moderate alcohol consumption and the relative risks (RR) attributed to various measureable CHD serological biomarkers. Thus, the possible reasons for the reduced RR for CHD with moderate alcohol consumption become clear at a glance. Conclusions An integrated high-level model of CHD, its pathogenesis, biomarkers, and moderate alcohol consumption provides a summary of the evidence that a causal relationship between CHD risk and moderate alcohol consumption may exist. It also shows the importance of each CHD pathway that moderate alcohol consumption influences.
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Affiliation(s)
- Marc J Mathews
- CRCED, North-West University, and Consultants to TEMM International (Pty) Ltd, P.O. Box 11207, Silver Lakes, 0054, South Africa.
| | - Leon Liebenberg
- CRCED, North-West University, and Consultants to TEMM International (Pty) Ltd, P.O. Box 11207, Silver Lakes, 0054, South Africa.
| | - Edward H Mathews
- CRCED, North-West University, and Consultants to TEMM International (Pty) Ltd, P.O. Box 11207, Silver Lakes, 0054, South Africa.
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