Sex-specific fifteen-year alcohol consumption trajectories and their association with cardiovascular events and mortality: The Framingham Heart Study

Alcohol use patterns influence health outcomes. A study examined sex-specific drinking trajectories and their associations with all-cause mortality and coronary heart disease (CHD) in the US-based Framingham Heart Study. Among 6570 participants (mean age: 55 ± 13; 55% women) followed for 15 years, a growth mixture model identified four sex-specific alcohol consumption trajectories. Cox models examined associations of alcohol trajectories with CHD and mortality over 10 years of follow-up, adjusting for covariates.
The study identified four distinct, sex-specific alcohol consumption trajectories: the Moderate-Decreasing group (1179 women, 0-14 g/day; 1534 men, 0-28 g/day) showed a declining moderate intake; The Low-to-None group included light or non-drinkers (992 women, 826 men); the Inverse-U group (606 women, 199 men) showed variable intake over time; while the High-Decreasing group (858 women, 376 men) had high initial consumption (women > 14 and men > 28 g/day) that declined over time. Compared with the Moderate-Decreasing group, women in other groups had higher CHD risks (HRs 1.58-1.61) and greater mortality risk in the Low-to-None (HR 1.25) and Inverse-U (HR 1.28) groups. Men in Low-to-None had higher mortality (HR 1.17) and CHD (HR 1.60), while High-Decreasing showed the highest mortality (HR 1.27). Low-to-moderate drinking was associated with lower mortality and CHD risks; however, these findings do not confirm the protective effects of alcohol use.
The study findings suggest that sustained low to moderate drinking was associated with lower risks of mortality and CHD in both women and men, compared to high-level or fluctuating patterns. Although these associations may not confirm causality, the findings emphasise the importance of investigating long-term drinking patterns in public health. Nevertheless, we caution against promoting moderate alcohol consumption as a strategy to reduce mortality risk or prevent CHD.
Source: Leng, Y., Ding, H., Li, Y., Liu, X., Wang, M., Cao, Y., Lyu, C., Levy, D., Ma, J., Liu, C. 92026) Sex-specific fifteen-year alcohol consumption trajectories and their association with cardiovascular events and mortality: The Framingham Heart Study. Nutrients, 18(5), 849.