ALCOHOL INTAKE AND INCIDENCE OF CORONARY DISEASE IN AUSTRALIAN ABORIGINES

Abstract — Aims: To examine risk for coronary heart disease (CHD) and cardiovascular disease (CVD) in relation to alcohol in a cohort of Australian Aborigines. Methods: In 1988–1989, alcohol intake, drinking pattern, and beverage preference were elicited by interviewer-administered questionnaire in Western Australian Aborigines (258 men, 256 women) and cardiovascular outcomes ascertained through linkage to mortality and hospital admission records to 2002. Results: In proportional hazards models, risk for CHD, relative to lifetime abstainers, was significantly increased in ex-drinkers [Hazard ratio (HR) 2.29, 95 % CL 1.23, 4.27], those drinking 41–60 g/day in men or 21–40 g/day in women (HR 2.80, 95 % CL 1.04, 7.53), and those drinking>150 g/day for men or>100 g/day for women (HR 2.25, 95 % CL 1.03, 4.90) with a J-shaped relationship. Low-to-moderate drinkers had lower waist girth, exercised more, and had a lower prevalence of overweight and smoking than at-risk drinkers. A preference for wine was associated with lower HR (0.28, 95 % CL 0.10, 0.95). With CVD, only ex-drinkers showed significantly increased risk (HR 1.87, 95 % CL 1.20, 2.91). Conclusions:More favourable health-related behaviours in low-to-moderate drinkers suggest that lower risk could be mediated by lifestyle, as proposed in other populations. Epidemiological studies suggest that light to moderate alcohol intake may be protective against coronary heart disease (CHD) (Gronbaek, 2002), a finding supported by meta-analyses (McClure, 1993; Corrao et al., 2000). A U- or J-shaped rela-tionship between coronary endpoints and alcohol intake i