Twenty-year trajectories of alcohol consumption during midlife and atherosclerotic thickening in early old age: findings from two British population cohort studies.
BACKGROUND
Epidemiological evidence indicates a protective effect of light-moderate drinking on cardiovascular disease and an increased risk for heavier drinking. Nevertheless, the effect of alcohol on atherosclerotic changes in vessel walls is disputed. Most previous studies have only looked at the cross-sectional relationship between alcohol and carotid intima media thickness (cIMT) - a surrogate marker of atherosclerosis. Single measurements of alcohol assume that alcohol exposure is stable and ignore the possible cumulative effects of harm, leading to possibly incorrect inferences.


METHODS
Data were retrieved from two UK population based cohort studies: the Whitehall II cohort of civil servants and the MRC National Survey of Health and Development (combined sample size of 5403 men and women). Twenty year-drinking trajectories during midlife were linked to measures of cIMT when participants were in early old age, and adjusted for age, sex, socioeconomic position, ethnicity and smoking.


RESULTS
Those who consistently drank heavily had an increased cIMT compared to stable moderate drinkers (pooled difference in cIMT 0.021 mm; 95 % CI 0.002 to 0.039), after adjustment for covariates. This was not detected in cross-sectional analyses. Former drinkers also had an increased cIMT compared to moderate drinkers (pooled difference in cIMT 0.021; 95 % CI 0.005 to 0.037). There were no appreciable differences in cIMT between non-drinkers and consistent moderate drinkers.


CONCLUSION
The drinking habits among adults during midlife affect the atherosclerotic process and sustained heavy drinking is associated with an increased cIMT compared to stable moderate drinkers. This finding was not seen when only using cross-sectional analyses, thus highlighting the importance of taking a life course approach. There was no evidence of a favourable atherosclerotic profile from stable moderate drinking compared to stable non-drinking.
['Britton|Annie|A|', 'Hardy|Rebecca|R|', 'Kuh|Diana|D|', 'Deanfield|John|J|', 'Charakida|Marietta|M|', 'Bell|Steven|S|']
D000367:Age Factors D000368:Aged D000428:Alcohol Drinking D050197:Atherosclerosis D015992:Body Mass Index D059168:Carotid Intima-Media Thickness D002784:Cholesterol D015331:Cohort Studies D003430:Cross-Sectional Studies D005006:Ethnicity D006801:Humans D008019:Life Style D008875:Middle Aged D012307:Risk Factors D012907:Smoking D006113:United Kingdom
Alcohol Atherosclerosis Life course Longitudinal