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(Circulation. 2000;102:489.)
© 2000 American Heart Association, Inc.

Editorial

Alcohol Consumption, Diabetes, and Coronary Disease

An Epidemiological Perspective

William S. Weintraub, MD

From the Division of Cardiology, Emory University School of Medicine, Atlanta, Ga.

Correspondence to William S. Weintraub, MD, Division of Cardiology, Emory University School of Medicine, 1639 Pierce Dr, WMB 319, Atlanta, GA 30322. E-mail bill@ecor.eushc.org

Key Words: Editorials • alcohol • diabetes mellitus • coronary disease

Coronary artery disease and diabetes mellitus are common, serious medical conditions, with diabetes being a serious risk factor for coronary events as well. Although some data suggest that mild to moderate alcohol consumption may be beneficial in preventing coronary events, there is natural concern about the safety of even moderate alcohol consumption for diabetics who suffer from increased risk of coronary disease and may seek to use alcohol therapeutically to decrease their risk.

This important concern is addressed by Ajani et al in the current issue of Circulation.¹ Alcohol consumption was defined by survey collected at baseline. Diabetes was considered to be present if the participant gave a history of diabetes or used insulin or other antidiabetic medication. Follow-up was 5.5 years, with mortality assessed from the National Death Index and cause of death confirmed from death certificates. The authors examined the outcomes of 87 938 US physicians, among whom there were 2790 diabetics. There were 850 deaths due to coronary heart disease, 717 in nondiabetics and 133 in diabetics. The effect of alcohol consumption on mortality was expressed as the relative risk, adjusted for other risk factors. Risk is the probability of an event. Relative risk is the risk of an event in a group with a risk factor divided by risk in the group without the risk factor. Thus, relative risks <1 mean the risk factor is actually protective. In the nondiabetics, the relative risks for coronary deaths, compared with those who drank no alcohol, were 1.02 . . . [Full Text of this Article]