Alcohol consumption and risk of coronary heart disease among Chinese men

Background: Observational studies suggest that moderate alcohol consumption may lower risk of myocardial infarction (MI) and coronary heart disease (CHD); yet, evidence for this comes almost entirely from Western populations. Methods: We conducted a prospective cohort study in 64,597 Chinese men aged >= 40 years who were free of clinical CHD at baseline examination. Data on frequency and type of alcohol consumed were collected at the baseline examination in 1991 using a standard protocol. Follow-up evaluation was conducted in 1999-2000, with a response rate of 94%. Results: Over 494,084 person-years of follow-up, we documented 725 (361 fatal) incident MI and 976 (588 fatal) incident CHD events. After stratification by province to account for multi-stage sampling design and adjustment for age, education, physical activity, cigarette smoking, body mass index, systolic blood pressure, urbanization ( urban vs. rural), geographic variation (north vs. south) and history of diabetes, relative risk (95% confidence interval) of MI was 0.93 (0.70-1.24) for participants consuming 1 to 6 drinks/week, 0.66 (0.54-0.82) for those consuming 7 to 34 drinks/ week, and 0.58 (0.41-0.81) for those consuming = 35 drinks/ week ( p for linear trend <0.0001) compared to nondrinkers. The corresponding relative risks for CHD events were 0.99 (0.77-1.27), 0.67 (0.56-0.81), and 0.58 (0.44-0.78), respectively ( p for linear trend <0.0001). Conclusion: Alcohol consumption may be related to lower risk of MI and CHD in middle-aged and older Chinese men. However, heavy alcohol consumption may lead to increased mortality from other causes; therefore, the implications of these findings should be interpreted cautiously. (C) 2008 Elsevier Ireland Ltd. All rights reserved.