From the Department of Neurology (S.K., J.W.), Innsbruck University
Clinic, Innsbruck, Austria; the Department of Internal Medicine (G.E., F.O.),
Bruneck Hospital, Bruneck, Italy; and the Department of Endocrinology and
Metabolism (E.B.), University of Verona, Verona, Italy.
Correspondence to Dr S. Kiechl, Department of Neurology, Innsbruck University Hospital, Anichstr. 35, A-6020 Innsbruck, Austria.
Background and Purpose—Potential
effects of regular alcohol consumption on atherogenesis are still
controversial mainly due to the lack of prospective
population-based studies.
Methods—The Bruneck Study is a prospective population-based
survey of atherosclerosis and its risk factors. The
study population comprises a sex- and age-stratified random sample of
men and women aged 40 to 79 years. Participation and follow-up were
more than 90% complete. Changes in carotid
atherosclerosis between the 1990 baseline and the first
follow-up in 1995 were monitored by high-resolution duplex
ultrasonography. Alcohol intake was quantified with a standardized
questionnaire and prospective diet records.
Results—Alcohol consumption less than once a week
(occasional drinking) had no effect on atherogenesis. The association
between regular alcohol intake and incident carotid
atherosclerosis (early atherogenesis) was J-shaped,
with light drinkers facing a lower risk than either heavy drinkers or
abstainers. Protection offered by alcohol consumption of <50 g/d
appeared to act through inhibition of the injurious action of high
levels of low-density lipoprotein (LDL) cholesterol. Excess
risk of incident atherosclerosis observed among heavy
alcohol consumers (
Conclusions—Our findings support the view that adverse and
beneficial effects of alcohol on arterial disease are
mediated in part by a dose-dependent promotion or deceleration of
atherogenesis. The protection afforded by light drinking may possibly
be attributed to antithrombotic effects and inhibition of the
atherogenic action of high levels of LDL cholesterol.
© 1998 American Heart Association, Inc.
Original Contributions
Alcohol Consumption and Atherosclerosis: What Is the Relation?
Prospective Results From the Bruneck Study
100 g/d) clearly surpassed the risk burden
afforded by heavy smoking. The association between regular alcohol
intake and incident carotid stenosis (advanced atherogenesis)
was U-shaped. Odds ratios were generally shifted toward protection and
did not rely on LDL cholesterol levels. We failed to find
any differential effects of alcohol from various sources. All
associations remained independently significant when we adjusted for
lifestyle, coincidental smoking, and the metabolic complex
associated with drinking.
Key Words: alcohol drinking • atherosclerosis • carotid artery disease • lipid peroxidation • lipoproteins, LDL
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