Abstract
Introduction: Moderate alcohol consumption has been shown to protect against coronary artery disease (CAD) in the general population, but this relationship has not been well studied among U.S. Veterans. Methods: 61,587 Million Veteran Program (MVP) participants completed a baseline and lifestyle survey that included questions about frequency and volume of alcohol consumption. We combined grams of ethanol in wine, beer, and spirits to create the exposure variable for this analysis. Using the VA electronical health record, incident CAD events included myocardial infarction, angina pectoris, other forms of chronic ischemic heart disease (ICD9 codes 410-414.9) or coronary procedures (ICD9 procedure codes 36.0-36.99). Participants with prevalent CAD (n=27,844) before the baseline survey date or alcohol abuse using ICD9 codes 303.0 and 305.0 (n=16,048) were excluded from the analysis. We used a Cox Proportional Hazard model to estimate hazard ratios (HR) and 95% confidence intervals (CI) for CAD adjusting for age, sex, body mass index, and smoking status. Results: Among 59,288 participants analyzed, the mean age was 65y (SD=11.9), mean BMI was 28.9 kg/m 2 , 90% were men, 33% were never smokers, 86% self-reported as White, 11% Black, and 6% Hispanic. Participants were categorized into 6 alcohol consumption categories: Never, former, and current drinkers of half drink/d, >half to 1 drink/d, >1 to 2 drinks/d, >2 to 3 drinks/d, >3 to 4 drinks/d, and >4 drinks/d. During a mean follow up of 3.3 years, 3,670 CAD events were documented. Using current drinkers of ≤half a drink/d as the reference group, we found a 19% lower risk of CAD in drinkers of >1 to 2 drinks/d, a 25% lower risk of CAD with alcohol intake of >3 to 4 drinks/d, and 34% lower risk in the highest alcohol category in a multivariable adjusted model (Table 1). As expected, former drinkers had a slightly higher risk of CAD. We did not have enough data on women to conduct sex-specific analyses. Conclusion: Our data show a lower risk of CAD with moderate alcohol consumption among MVP participants.
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