Am J Clin Nutr. 2022 Jun 10:nqac159. doi: 10.1093/ajcn/nqac159. Online ahead of print.
BACKGROUND: The causal effects of moderate alcohol consumption on cardiovascular diseases (CVDs) are continuously debated, especially on coronary heart disease (CHD).
OBJECTIVES: We aimed to explore the causal associations of alcohol consumption with CVDs and all-cause mortality among Chinese males.
METHODS: A prospective cohort study was conducted in 40,386 Chinese males, with 17,676 being genotyped for the rs671 variant in the aldehyde dehydrogenase 2 (ALDH2) gene. Cox proportional hazards model was conducted to estimate the effects of self-reported alcohol consumption. Mendelian randomization (MR) analysis was performed to explore the causality using rs671 as an instrumental variable.
RESULTS: During the follow-up of 303,353 person-years, 2,406 incident CVD and 3,195 all-cause mortality were identified. J-shaped associations of self-reported alcohol consumption with incident CVD and all-cause mortality were observed, showing decreased risks for light (≤25 g/day) and moderate drinkers (25-≤60 g/day). However, MR analyses revealed a linear association of genetically predicted alcohol consumption with the incident CVD (Ptrend = 0.02), including both CHD (Ptrend = 0.03) and stroke (Ptrend = 0.02). The HRs (95% CIs) for incident CVD across increasing tertiles of genetically predicted alcohol consumption were 1 (reference), 1.18 (1.01, 1.38), and 1.22 (1.03, 1.46). After excluding heavy drinkers, the risk of incident CVD and all-cause mortality was increased by 27% and 20% per standard drink increment of genetically predicted alcohol consumption, respectively.
CONCLUSIONS: Our analyses extend the evidence of the harmful effect of alcohol consumption to total CVD (including CHD) and all-cause mortality, highlighting the potential health benefits of lowering alcohol consumption, even among light-to-moderate male drinkers.