Risk and protective effects of combined moderate and binge drinking on cardiovascular disease

Alcohol consumption is unique among the leading risk factors of chronic diseases because alcohol it is not unambiguously harmful. In most cases the health consequences of alcohol consumption is negative, but for cardiovascular diseases this seems to be mixed. Heavy alcohol use and episodes of binge drinking has been related to adverse cardiovascular health, but light to moderate drinking seems to give reduced risk. Seemingly, one would expect the protective effect of a moderate intake to be more pronounced in individuals who do not binge drink and not present or reduced in individuals who frequent indulge in such episodes. This is an important public health issue and is important for future health policy. We have shown that the risk of death and, in part, also death from cardiovascular disease is higher among those with an episodic high alcohol intake in a population that included people with and without established cardiovascular disease, but we will also investigate this isolated among people who do not have previous illness and with more accurate control over how much on average they drink over time. Traditional Norwegian alcohol policy is based on keeping total consumption low and thereby reduce unhealthy drinking pattern. This policy rests on a principle of solidarity that anyone can experience the health consequences which follows this level of drinking. , however, this principle is now under pressure The effect of alcohol consumption on cardiovascular diseases seems to be influenced by underlying factors among individuals and may therefore be divergent. These may be important issues for policy makers when balancing liberal alcohol policies against population wide measures to reduce total consumption. Our project will pay attention to this and to what extent psychosocial factors, including cognitive ability, may also be important for the divergent roles of alcohol on cardiovascular diseases. We find that alcohol consumption among people who had less fortunate socio-economic conditions throughout their lives was more strongly associated with the risk of death and death from cardiovascular disease than among people who had been more fortunate. We also find evidence that cognitive ability may be an underlying factor affecting both alcohol intake towards a higher intake and a healthier lifestyle, partly through selection into education. We will also study the importance of mental health for the relationships between alcohol and cardiovascular disease. As both alcohol consumption and risk of cardiovascular diseases are more common in some families, the project aims to describe this family patterning of risk and see if considering this is relevant to the health consequences of alcohol. The project will benefit from large health surveys that combine both questions on moderate and binge drinking, and link this to hospital discharge data.

Prosjektet har studert sammenheng mellom moderat og episodisk høyt forbruk av alkohol med senere risiko for hjerte- og karsykdom. Vi har brukt data fra norske helseundersøkelser som samlet sett har gjort det mulig å studere om alkohol forbruk er mer skadelig i undergrupper i befolkningen.

Alcohol consumption is among the top ten leading risk factors in the global burden of disease. For most health outcomes the effects of alcohol is negative, but for cardiovascular diseases the effects seem to be mixed. Chronic heavy alcohol use has been associated with adverse cardiovascular outcomes. But light to moderate drinking seems to be related to reduced risk of ischemic diseases. If moderate alcohol consumption is protective against CVD and binge drinking is detrimental, one would expect the protective effect to be more pronounced in individuals who do not binge drink and not present in individuals who report episodes of binge drinking. This is a significant public health issue and is important for future policy development. Traditional Norwegian alcohol policy based on keeping total consumption low to avoid more people becoming problem drinkers is under pressure. This policy rests on a solidarity premise that anyone can potentially experience health consequences of alcohol abuse. However, the scientific evidence base for population wide approaches is challenged because the effect of alcohol consumption on CVD appears to be divergent. Alcohol consumption might also be influenced by underlying factors, which calls for a reconsidering on the issue of human agency in policy formulation. Our project will pay attention to this and to what extent psychosocial factors including cognitive ability, may interact with the divergent roles of alcohol on cardiovascular diseases. As both alcohol consumption and risk of CVD are clustered within families, the project aims to describe this shared patterning of risk and see if the protective effect and risk associated with moderate and binge drinking is attenuated when accounting for shared family factors. Internationally there is sparse data from health surveys that combine both questions on moderate and binge drinking. Norwegian health surveys linked to hospital discharge data on CVD and linkages to multigenerational data.