Lifetime drinking trajectories and nonfatal acute myocardial infarction 

The relation of lifetime drinking trajectories to coronary heart disease is not well understood. A research project identified cases hospitalised for a nonfatal acute myocardial infarction (AMI) and healthy population-based controls matched on age and sex. Individuals completed a physical examination and an interview covering known AMI risk factors and a detailed lifetime drinking history. Distinct lifetime drinking trajectories based on ounces of ethanol consumed per decade between ages 10 and 59 years were derived and characterised according to lifetime drinking patterns associated with each. Analyses were conducted to estimate AMI risk among participants who never drank regularly compared to lifetime drinking trajectories and risk associated with distinct trajectories among former and current drinkers.
Two lifetime drinking trajectories were derived, early peak and stable. Early peak trajectories were characterised by earlier onset of regular drinking, less frequent drinking, more drinks per drinking
day, fewer total drinks, more frequent drunkenness per drinking year, and reduced alcohol intake or abstention by middle age.
Never drinking regularly, reported by significantly more women than men, was associated with significantly higher AMI risk than stable lifetime drinking trajectories among men and in the sex-combined analysis of former drinkers only. Compared to stable lifetime drinking trajectories, early peak trajectories were associated with significantly higher AMI risk among male former drinkers, among sex-combined former drinkers, and among female current drinkers.
The authors comment that epidemiological studies of alcohol and health in populations over age 35 may have underestimated the impact of heavy episodic drinking during adolescence and emerging adulthood on the cardiovascular system. Source: Lifetime Drinking Trajectories and Nonfatal
Acute Myocardial Infarction.Russell M, Fan AZ, Freudenheim JL, Dorn J, Trevisan M. Alcohol Clin Exp
Res. 2019 Nov;43(11):2384-2394.