Alcohol consumption in relation to carotid subclinical atherosclerosis and its progression: results from a European longitudinal multicentre study

Abstract

Background/aim: The association between alcohol consumption and subclinical atherosclerosis is still unclear. Using data from a European multicentre study, we assess subclinical atherosclerosis and its 30-month progression by carotid intima-media thickness (C-IMT) measurements, and correlate this information with self-reported data on alcohol consumption.

Methods: Between 2002-2004, 1772 men and 1931 women aged 54-79 years with at least three risk factors for cardiovascular disease (CVD) were recruited in Italy, France, Netherlands, Sweden, and Finland. Self-reported alcohol consumption, assessed at baseline, was categorized as follows: none (0 g/d), very-low (0 - 5 g/d), low (> 5 to ≤ 10 g/d), moderate (> 10 to ≤ 20 g/d for women, > 10 to ≤ 30 g/d for men) and high (> 20 g/d for women, > 30 g/d for men). C-IMT was measured in millimeters at baseline and after 30 months. Measurements consisted of the mean and maximum values of the common carotids (CC), internal carotid artery (ICA), and bifurcations (Bif) and whole carotid tree. We used quantile regression to describe the associations between C-IMT measures and alcohol consumption categories, adjusting for sex, age, physical activity, education, smoking, diet, and latitude.

Results: Adjusted differences between median C-IMT values in different levels of alcohol consumption (vs. very-low) showed that moderate alcohol consumption was associated with lower C-IMT_max[- 0.17(95%CI - 0.32; - 0.02)], and Bif-IMT_mean[- 0.07(95%CI - 0.13; - 0.01)] at baseline and decreasing C-IMT_mean[- 0.006 (95%CI - 0.011; - 0.000)], Bif-IMT_mean[- 0.016(95%CI - 0.027; - 0.005)], ICA-IMT_mean[- 0.009(95% - 0.016; - 0.002)] and ICA-IMT_max[- 0.016(95%: - 0.032; - 0.000)] after 30 months. There was no evidence of departure from linearity in the association between alcohol consumption and C-IMT.

Conclusion: In this European population at high risk of CVD, findings show an inverse relation between moderate alcohol consumption and carotid subclinical atherosclerosis and its 30-month progression, independently of several potential confounders.

Keywords: Alcohol drinking; Atherosclerosis; Carotid intima-media thickness; Epidemiology; Progression.

Fig. 1

a, b Dose–response relationships between alcohol consumption and each of the considered measurements of C-IMT (p50) at baseline (a) and progression (b). Solid lines: Restricted cubic splines adjusted for sex, age, physical activity, smoking, diet, and latitude, with knots located at fixed points of g/d of alcohol consumption (4, 10, 20, 30). Dashed lines: 95% CI. 4 g/day was used as a reference point. P for nonlinearity was obtained testing the nullity of the coefficients associated with the second, third and fourth spline basis. For a better readability of the graphs, we excluded participants with alcohol consumption > 50 g/d

Fig. 1

a, b Dose–response relationships between alcohol consumption and each of the considered measurements of C-IMT (p50) at baseline (a) and progression (b). Solid lines: Restricted cubic splines adjusted for sex, age, physical activity, smoking, diet, and latitude, with knots located at fixed points of g/d of alcohol consumption (4, 10, 20, 30). Dashed lines: 95% CI. 4 g/day was used as a reference point. P for nonlinearity was obtained testing the nullity of the coefficients associated with the second, third and fourth spline basis. For a better readability of the graphs, we excluded participants with alcohol consumption > 50 g/d