The validity of alcohol intake on ...

The validity of alcohol intake on cardiovascular mortality has been described as a U- or J-shaped relationship; however, the exact mechanisms of reduction in mortality in moderate alcohol consumption are unknown. Albert and colleagues studied the association of alcohol and C-reactive protein (CRP) from one side a cross-sectional survey of patients participating in the Pravastatin Inflammation/CRP Evaluation (PRINCE) consideration which was a multi-center community-based trial that investigated the import of pravastatin on CRP levels

The reflection by Albert and colleagues included 1679 patients without a history of myocardial infarction, reverse or coronary revascularization (primary prevention arm) and 1154 patients with a history of cardiovascular disease (secondary prevention arm). Participants were asked to define their alcohol intake in united of the following ways: no alcohol intake or les than the same drink monthly; one to three drinks by month; one to four drinks through week; five to seven drinks through week; or at least sum of two units drinks daily. Baseline levels and mean change in CRP and lipid on a levels over six months were calculated for each alcohol category. The data were analyzed to compare baseline cardiovascular risk factors and alcohol consumption; to assess the relationship of alcohol intake and CRP overall and among various subgroups; to evaluate the correlation of alcohol and change in lipid parameters throughout time; and to assess for interactions between alcohol intake, pravastatin allocation, and change in CRP or lipid flushs over time. CRP levels were higher in somebodys with a history of cardiovascular disease compared with those without as it is a history, and were higher in women than in men In nearly all of the subgroup moderate alcohol consumption (five to seven drinks weekly) and heavy alcohol consumption were significantly associated with the lowest baseline CRP flushs The relationship was less significant in women taking hormone therapy.

The authors acknowledge the following weaknesses in the study: the cross-sectional design limits direct determination of causality; self-reporting of alcohol consumption horizontals may have been inaccurate and may have ariseed in underestimated true consumption; the prototypes of alcoholic beverages were not described and may have theoretic limitations; and CRP plains were similar in moderate and heavy drinkers, possibly because of the smaller sample sizes in the heavy alcohol intake groups

The authors decide that alcohol use may lower cardiovascular mortality in part from one side an anti-inflammatory mechanism. The meditation further confirms the benefit of moderate alcohol use upon mortality, but caution is advised when discussing the benefits with patients in light of the well-known health concatenations associated with alcohol abuse.

Albert MA, et al. Alcohol consumption and plasma concentration of C-reactive protein. Circulation January 28 2003;107:443-7

COPYRIGHT 2003 American Academy of Family Physicians

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