Long-term alcohol consumption has a detrimental effect on both blood pressure (BP) and body mass index (BMI), according to a study published March 14 in the European Heart Journal.

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The study used variants in ADH1B and ADH1C genes as instrumental variables (IV) to estimate the causal effect of long-term alcohol consumption on BMI, BP, lipids, fibrinogen and glucose in 54,604 Danish participants with a mean age of 56 years. Overall, the study found a higher BP and a higher BMI in patients drinking more alcohol – findings that are consistent with East Asian population studies that have used the ALDH2 variant. For BP, HDLc and fibrinogen, the multivariable and IV analyses were consistent and suggested that not drinking any alcohol was associated with lower BP and HDLc and higher fibrinogen. In the IV analyses, non-drinking was associated with lower BMI and higher triglyceride levels. Alcohol was not associated with non-HDLc or glucose in either group.

In terms of a link between moderate alcohol consumption and lower coronary heart disease (CHD) risk, the study authors note that given the results from this and other studies, it "seems unlikely that if moderate alcohol consumption is causally related to lower CHD risk this is mediated via HDLc or fibrinogen." Instead they suggest that improved insulin sensitivity might mediate a potential beneficial effect, but that would need to be tested. They also highlighted the "surprising" results in the IV analyses showing a possible benefit of alcohol consumption on triglyceride levels. "Recent evidence suggests that cholesterol in remnants, rather than triglyceride levels per se causes greater CHD, and our result regarding triglyceride levels may be a proxy for remnant cholesterol as the two are highly correlated," they said. Further validation of these results, however, is necessary. "We accept that our finding related to this outcome should be treated with caution unless it is replicated," they said.

Keywords: Ethanol, Lipids, Coronary Disease, Blood Pressure, Insulin Resistance, Glucose, Cholesterol, Body Mass Index, Fibrinogen, Hypertension

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