Beneficial effect alcohol on lipids offset by increased BP in heavy drinkers

20 November 2008



The beneficial effect of alcohol consumption on serum lipids is offset by increases in blood pressure (BP) in heavy drinkers, resulting in an overall increase in estimated 10-year coronary artery disease (CAD) risk, report researchers.

“Moderate alcohol consumption has been associated with lower CAD risk,” note Nicolas Rodondi (University of Lausanne, Switzerland) and colleagues.

“However, data on the CAD risk associated with high alcohol consumption are conflicting,” they add.

To investigate further, they carried out a population-based study of 5769 Swiss adults aged 35–75 years who ranged from nondrinkers to individuals who consumed over 35 drinks per week.

The researchers classified participants as nondrinkers, moderate consumption (1–13 drinks/week), high consumption (14–34 drinks/week), and very high consumption (35 drinks/week or above).

The study population comprised 27% nondrinkers, 55% moderate consumers, 16% high consumers, and 2% very high consumers.

Multivariate analysis showed an association between increasing alcohol consumption and increasing high-density lipoprotein (HDL) cholesterol, with nondrinkers having an average HDL cholesterol level of 1.57 mmol/l (60.71 mg/dl), rising to 1.88 mmol/l (72.70 mg/dl) for very high consumers.

For the same groups, triglycerides, systolic BP, and diastolic BP rose from an average of 1.17 mmol/l (103.63 mg/dl), 127.4 mmHg, and 78.7 mmHg to 1.32 mmol/l (116.91 mg/dl), 132.2 mmHg, and 81.7 mmHg, respectively.

The researchers note that the rise in HDL cholesterol appeared to be linked mostly to wine consumption, whereas the increase in triglycerides was associated with consumption of beer and spirits, but not wine.

The 10-year CAD risk for nondrinkers was 4.31%. Although this risk was below 4.31% for all moderate and some heavy drinkers, it increased to 4.56% for those who drank 21 drinks a week or more.

Rodondi et al conclude that “as measured by 10-year CAD risk, the protective effect of alcohol consumption disappears in very high drinkers, because the beneficial increase in HDL cholesterol is offset by the increases in BP levels.”

These results are published in the American Journal of Cardiology.

Am J Cardiol 2008; Advance online publication