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Alcohol consumption and the risk of coronary heart disease in postmenopausal women with diabetes: Women’s Health Initiative Observational Study

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Abstract

Background

Although several observational studies have consistently reported an inverse association between moderate alcohol consumption and risk of coronary heart disease (CHD), it is yet not well established if this association also exists among people with type 2 diabetes. The aim of this study is to evaluate the association between the frequency and quantity of alcohol intake and the risk of developing CHD among postmenopausal women with diabetes.

Methods

We conducted a prospective cohort study, which included 3,198 women with self-reported diabetes and without any history of cardiovascular disease at baseline, in the Women’s Health Initiative Observational Study. Alcohol intake was assessed by a semiquantitative food frequency questionnaire. The primary outcome of this study was CHD, which was validated by medical record review. Cox proportional hazards regression was used to estimate the hazard ratio (HR) for the association of alcohol intake and risk of incident CHD while adjusting for several potential confounders.

Results

During the 22,546 person-years of follow-up, there were 336 incident cases of CHD. Both frequency and quantity of alcohol intake were inversely associated with the risk of developing CHD. Compared to nondrinkers, the multivariable HRs across categories of frequency of alcohol consumption (≤0.5, 0.5–2 and ≥2 drinks/week) were 0.89 (95% confidence intervals [CI]: 0.63, 1.26), 0.84 (95% CI: 0.56, 1.25) and 0.65 (95% CI: 0.43, 0.99), respectively (p for trend: 0.04). This association did not appear to differ based on the type of the alcoholic beverage consumed.

Conclusions

Moderate alcohol consumption of postmenopausal women with type 2 diabetes may have a benefit on CHD similar to that seen in postmenopausal nondiabetic women. The potential risks of alcohol on noncardiac outcomes may need consideration when recommending alcohol to women with diabetes.

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Acknowledgments

The Women’s Health Initiative (WHI) Program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 42107-26, 42129-32 and 44221. The study sponsors had no role in the design of the study; the collection, analysis and interpretation of the data; the writing of the manuscript or the decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke or the National Institutes of Health. The complete list of WHI centers and investigators can be found online at http://www.whiscience.org/collaborators/investigators.php.

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Authors and Affiliations

  1. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, 10461, USA

    Swapnil N. Rajpathak, Cuiling Wang, Judith Wylie-Rosett, Rachel P. Wildman, Thomas E. Rohan & Sylvia Wassertheil-Smoller

  2. Departments of Medicine and Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA

    Mathew S. Freiberg

  3. Departments of Epidemiology and Medicine, University of Iowa, Iowa City, IA, USA

    Jennifer G. Robinson

  4. Department of Epidemiology, University of California at Los Angeles, Los Angeles, CA, USA

    Simin Liu

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  1. Swapnil N. Rajpathak
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Correspondence to Swapnil N. Rajpathak.

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Rajpathak, S.N., Freiberg, M.S., Wang, C. et al. Alcohol consumption and the risk of coronary heart disease in postmenopausal women with diabetes: Women’s Health Initiative Observational Study. Eur J Nutr 49, 211–218 (2010). https://doi.org/10.1007/s00394-009-0065-3

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