Effects of moderate and high doses of alcohol on carotid atherogenesis

Alcohol consumption may be a risk factor for cerebrovascular stenosis in acute ischemic stroke and transient ischemic attack

BACKGROUND

Atherosclerosis are well established risk factors for ischemic stroke, however the association between alcohol consumption and atherosclerosis is controversial. This study aims to explore the potential correlation between alcohol consumption and cerebral stenosis in patients with acute ischemic stroke and transient ischemic attack (TIA).

METHODS

Nine hundreds and eighty-eight patients with first acute ischemic stroke attack or TIA were recruited retrospectively. Alcohol consumption was classified into five consumption categories (non-drinkers, occasional drinkers, < 140 g per week [mild drinkers], 140-279 g per week [moderate drinkers], ≥ 280 g per week [heavy drinkers]). Computed tomography angiography (CTA) and digital subtraction angiography (DSA) were utilized to assess the carotid and cerebral artery in all patients. Five-step scale for degree of stenosis was applied: normal (0, 0 points), mild (< 50%, 1 point), moderate (50-69%, 2 points), severe (70-99%, 3 points), and occlusion (100%, 4 points).

RESULTS

The carotid and cerebral artery stenosis scores were positively correlated with moderate alcohol consumption (B = 1.695, P < 0.001). Compared with nondrinkers, moderate alcohol consumption had significant increasing risk of moderate carotid and cerebral artery stenosis (OR = 4.28, 95% CI: 1.47-12.49, P = 0.008) and severe stenosis (OR = 4.24, 95% CI: 1.55-11.64, P = 0.005) and occlusion (OR = 3.87, 95% CI: 1.65-9.06, P = 0.002). Compared with nondrinkers, heavy alcohol consumption patients had significant higher risk of carotid and cerebral artery occlusion (OR = 2.71, 95% CI: 1.36-5.41, P = 0.005).

CONCLUSIONS

Higher alcohol consumption may associate with higher risk and more severity of carotid and cerebrovascular stenosis.

Association between alcohol consumption and subclinical femoral atherosclerosis in smoking and non-smoking men: the AWHS study

BACKGROUND AND AIMS

Many addictive substances, such as tobacco and alcohol, influence atherosclerosis development. Whether or not tobacco's pro-atherosclerotic effect is influenced by alcohol consumption is unknown. We aimed to estimate the impact of alcohol intake on the presence of subclinical atherosclerosis in femoral arteries in smoking and non-smoking middle-aged men.

DESIGN, SETTING AND PARTICIPANTS

Cross-sectional analysis of a subset of the Aragon Workers Health Study (AWHS), comprising 2099 men with mean age 50.9 years without previous cardiovascular disease.

MEASUREMENTS

The presence of plaques in femoral arteries was assessed by high-resolution sonography. Self-reported alcohol consumption over the previous year was measured with a food frequency questionnaire. The sample was divided into four groups according to their daily grams of alcohol consumption ≤ 1 (abstainers), ≥ 2 to < 30, ≥ 30 to < 60 and ≥ 60 g/day. Participants were divided on ever-smoking (current and former) versus never-smoking strata in the main analysis.

FINDINGS

We did not find a significant association between the different levels of alcohol intake and the likelihood of developing femoral artery atherosclerosis in never-smokers. Ever-smoking was positively associated with femoral atherosclerosis overall [odds ratio (OR) = 3.00; 95% confidence interval (CI) = 2.40, 3.74; P < 0.001] and within each level of alcohol consumption. Atherosclerosis was lower in ever-smokers who consumed 2 g/day or more but less than 30 g/day with respect to those ever-smokers who were abstainers (OR = 0.70; 95% CI = 0.49, 0.99; P < 0.05). However, among these ever-smokers, atherosclerosis prevalence was still higher than among never-smokers who consumed alcohol in the same amount (2 g/day or more but less than 30 g/day) (OR = 2.73; 95% CI = 2.07, 3.61; P < 0.001).

CONCLUSIONS

Among middle-aged men, moderate alcohol consumption appears to be associated with lower prevalence of femoral artery subclinical atherosclerosis compared with alcohol abstinence only in ever-smokers.

Alcohol consumption in relation to carotid subclinical atherosclerosis and its progression: results from a European longitudinal multicentre study

Background/Aim

The association between alcohol consumption and subclinical atherosclerosis is still unclear. Using data from a European multicentre study, we assess subclinical atherosclerosis and its 30-month progression by carotid intima-media thickness (C-IMT) measurements, and correlate this information with self-reported data on alcohol consumption.

Methods

Between 2002–2004, 1772 men and 1931 women aged 54–79 years with at least three risk factors for cardiovascular disease (CVD) were recruited in Italy, France, Netherlands, Sweden, and Finland. Self-reported alcohol consumption, assessed at baseline, was categorized as follows: none (0 g/d), very-low (0 − 5 g/d), low (> 5 to  ≤ 10 g/d), moderate (> 10 to ≤ 20 g/d for women,  > 10 to ≤ 30 g/d for men) and high (> 20 g/d for women, > 30 g/d for men). C-IMT was measured in millimeters at baseline and after 30 months. Measurements consisted of the mean and maximum values of the common carotids (CC), internal carotid artery (ICA), and bifurcations (Bif) and whole carotid tree. We used quantile regression to describe the associations between C-IMT measures and alcohol consumption categories, adjusting for sex, age, physical activity, education, smoking, diet, and latitude.

Results

Adjusted differences between median C-IMT values in different levels of alcohol consumption (vs. very-low) showed that moderate alcohol consumption was associated with lower C-IMT_max[− 0.17(95%CI − 0.32; − 0.02)], and Bif-IMT_mean[− 0.07(95%CI − 0.13; − 0.01)] at baseline and decreasing C-IMT_mean[− 0.006 (95%CI − 0.011; − 0.000)], Bif-IMT_mean[− 0.016(95%CI − 0.027; − 0.005)], ICA-IMT_mean[− 0.009(95% − 0.016; − 0.002)] and ICA-IMT_max[− 0.016(95%: − 0.032; − 0.000)] after 30 months. There was no evidence of departure from linearity in the association between alcohol consumption and C-IMT.

Conclusion

In this European population at high risk of CVD, findings show an inverse relation between moderate alcohol consumption and carotid subclinical atherosclerosis and its 30-month progression, independently of several potential confounders.

Electronic supplementary material

The online version of this article (10.1007/s00394-020-02220-5) contains supplementary material, which is available to authorized users.

[Alcohol consumption patterns and associated factors among elderly Brazilians: National Health Survey (2013)]

The scope of this study was to analyze the pattern of alcohol consumption among elderly Brazilians (60 years and over) and their association with sociodemographic factors, lifestyle habits and health conditions. This is a cross-sectional study of 10,537 elderly (90.1%) participants from the National Health Survey of 2013. The consumption of alcoholic beverages was classified as non-use, mild / moderate use and risk use. The multinomial regression model was used to study the associated factors. The prevalence for mild / moderate and risk use was 9.4% (95% CI: 8.4- 10.6%) and 4.6% (95%CI: 4.0-5.3%), respectively. The two consumption patterns were inversely associated with age and more frequent among men, better schooling, smokers and physical activity practitioners. Mild / moderate consumption was less frequent among non-whites and those with a history of stroke and diabetes, whereas risk use was less frequent among the elderly diagnosed for heart disease and more frequent among those suffering from depression. This result identifies profiles of greater vulnerability, with small differences between two patterns of consumption. This information should be considered in the preparation of proposals to promote healthy habits and control of alcohol use among the elderly.

Effects of different concentrations of sugarcane alcohol on food intake and nutritional status of male and female periadolescent rats

The present study evaluated the effects of food and alcohol intake on the nutritional and metabolic status of male and female periadolescent rats submitted to single (15%) and multiple (10%, 20%, 30%) concentrations of hydroalcoholic solutions of sugar-based alcohol associated with a feed mixture. Thirty-six periadolescent Wistar rats were used and randomly arranged into three groups: Group A (control; 0% ethanol; six males and six females), Group B (15% ethanol; six males and six females), and Group C (10%, 20%, and 30% ethanol; six males and six females). Food consumption, body weight, water intake (mL), ethanol intake (g/kg/day), ethanol preference in relation to water and different concentrations, and serum biochemical dosages (glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, very low-density lipoprotein fraction, triglycerides, cholesterol/HDL [CT/HDL], albumin) were analyzed. Males from Group C ingested more feed than females, which consumed reducing amounts throughout the weeks studied. Males also had heavier body weight, which increased throughout the experimental period. The animals ingested more water (females ingested more than males) in the first experimental week. Group C had a higher ethanol intake and greater preference for ethanol over water in both genders than Group B, which decreased over the subsequent weeks. Serum glucose was lower in Group A, whereas the CT/HDL ratio was lower in Group C. These findings allow the conclusion that nutritional and metabolic impact resulting from alcohol intake is different between genders and between the different forms in which the drug is offered. It is important to warn the population about the concentrations of alcohol intake, which may influence the growth and development of adolescents, thereby compromising their quality of life.

Binge drinking and the progression of atherosclerosis in middle-aged men: an 11-year follow-up

OBJECTIVE

There is limited knowledge on drinking patterns and the progression of atherosclerosis. Previous studies have shown conflicting results between alcohol consumption and atherosclerotic progression. We investigated the association between the pattern of binge drinking and the 11-year progression of carotid atherosclerosis in a population-based sample of middle-aged men.

METHODS AND RESULTS

This study is a part of the FinDrink Study, based on the Kuopio Ischemic Heart Disease Risk Factor Study. We investigated the effect of drinking patterns on the changes in maximum and mean intima-media thickness, including changes in maximum plaque height in 751 participants as measured by carotid ultrasound. The increased atherosclerosis progression was statistically significant among those men with binge drinking of >or=6 drinks per session (22.4% of total number of participants) using different covariates in different models according to the mean increase in maximum intima-media thickness (Model 1, p=0.008; Model 2, p=0.031, Model 3, p=0.037) and the mean increase in maximum plaque height (Model 1, p=0.002; Model 2, p=0.012, Model 3, p=0.017).

CONCLUSION

Our study shows that binge drinking was associated with an increased atherosclerosis progression during an 11-year follow-up in middle-aged men, independent of the total alcohol consumption.

Influência do etanol das bebidas alcoólicas na aterosclerose em artérias carótidas extracranianas

Existem fortes evidências de menor incidência de doença cerebrovascular oclusiva, de aterosclerose coronariana e de outros vasos em indivíduos com consumo leve ou moderado de álcool. Este estudo procura analisar o efeito do etanol, em diferentes doses no comportamento da aterosclerose carotídea extracraniana. Através do ultrassom Doppler colorido, foram investigadas 328 artérias carótidas extracranianas, de homens e mulheres brancos, com mais de 35 anos de idade, normotensos, não tabagistas e sem as principais doenças que constituam fatores de risco para doenças cardiovasculares. Foram divididos de acordo com o consumo de álcool por semana (em mililitros) em abstêmios, etilistas leves (1 a 100), moderados (101 a 300) e pesados (301 ou mais). Houve menor incidência de placas de aterosclerose e de estenose naqueles que ingeriram moderada quantidade. CONCLUSÃO: O estudo sugere uma ação protetora do álcool etílico para aterosclerose carotídea, quando ingerido em moderada quantidade.

Alcohol consumption and coronary atherosclerosis progression—the Stockholm Female Coronary Risk Angiographic Study

OBJECTIVE

To assess the association of alcohol intake with progression of coronary atherosclerosis. Although moderate drinkers have a lower risk of coronary heart disease than abstainers, the relation of alcohol use and coronary atherosclerosis has not been well studied.

METHODS AND RESULTS

In the Stockholm Female Coronary Risk Angiographic Study, we evaluated 103 women, aged 65 years or younger, hospitalized with acute myocardial infarction or unstable angina pectoris who underwent serial quantitative coronary angiography 3-6 months following their index event and repeated an average of 3 years and 3 months (range 2-5 years) later. Individual alcoholic beverage consumption was assessed by a standardized questionnaire. We used mixed model analysis to estimate the effect of alcohol consumption on progression of coronary atherosclerosis, as measured by mean luminal diameter change, controlling for age, smoking, body-mass index, education, physical activity, index cardiac event, menopausal status, diabetes, and history of dyslipidemia. Of the 93 women with complete information on alcohol intake, 14 consumed no alcohol (abstainers), 55 consumed up to 5 g of alcohol per day (light drinkers), and 24 consumed more than 5 g of alcohol per day (moderate drinkers). Coronary atherosclerosis progressed by a multivariate-adjusted average of 0.138 mm (95% confidence interval (CI): 0.027-0.249) among abstainers, 0.137 mm (95% CI: 0.057-0.217) among light drinkers, and -0.054 mm (95% CI: -0.154 to 0.047) among moderate drinkers (P < 0.001). The inverse association persisted in analyses stratified by index event. No beverage type appeared to confer particular benefit.

CONCLUSIONS

Among middle-aged women with coronary heart disease, moderate alcohol consumption (over 5 g/day) was protective of coronary atherosclerosis progression.

Effects of aldehyde dehydrogenase genotypes on carotid atherosclerosis

Atherosclerotic diseases are thought to be less frequent in Asians compared with Caucasians. Unlike Caucasians, nearly half of Asians have a functional deficiency in the low Km aldehyde dehydrogenase (ALDH2), a key enzyme in alcohol metabolism, which potentially modifies the prevalence of atherosclerosis. This study examined the associations between ALDH2 genotypes ("typical homo," "hetero" or "atypical homo") and carotid atherosclerosis in 304 Japanese patients. As a measure of carotid atherosclerosis, plaque score (PS) was evaluated by B-mode ultrasonography. Age- and sex-adjusted PS was lower in "atypical homo" genotype patients (2.7 +/- 1.2 [mean +/- standard error], n=21) (p<0.05) and tended to be lower in "hetero" patients (4.5 +/- 0.5, n=116) (p=0.07) compared with "typical homo" patients (5.7 +/- 0.4, n=167). When we controlled for traditional cardiovascular risk factors and alcohol intake, the "atypical homo" genotype was found to be associated with lower PS (beta=-0.13, p<0.05). Based on these findings, the ALDH2 genotypes seem to be associated with the severity of carotid atherosclerosis, potentially modifying the prevalence of atherosclerosis in Asians.