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Alcohol and Immediate CV risk

A systematic review and meta-analysis of the immediate cardiovascular risk (myocardial infarction, ischemic stroke, hemorrhagic stroke) of alcohol consumption.

 

 

Abstract

Background

Although considerable research describes the cardiovascular effects of habitual moderate and heavy alcohol
consumption, the immediate risks following alcohol intake have not been well characterized. Based on its physiological
effects, alcohol may have markedly different effects on immediate and long-term risk.

Methods and Results

We searched CINAHL, Embase, and PubMed from inception to March 12, 2015, supplemented with
manual screening for observational studies assessing the association between alcohol intake and cardiovascular events
in the following hours and days. We calculated pooled relative risks and 95% confidence intervals for the association
between alcohol intake and myocardial infarction, ischemic stroke, and hemorrhagic stroke using DerSimonian and Laird
random-effects models to model any alcohol intake or dose–response relationships of alcohol intake and cardiovascular
events. Among 1056 citations and 37 full-text articles reviewed, 23 studies (29 457 participants) were included. Moderate
alcohol consumption was associated with an immediately higher cardiovascular risk that was attenuated after 24 hours,
and even protective for myocardial infarction and hemorrhagic stroke (≈2–4 drinks: relative risk=30% lower risk) and
protective against ischemic stroke within 1 week (≈6 drinks: 19% lower risk). In contrast, heavy alcohol drinking was
associated with higher cardiovascular risk in the following day (≈6–9 drinks: relative risk=1.3–2.3) and week (≈19–30
drinks: relative risk=2.25–6.2).

Conclusions

There appears to be a consistent finding of an immediately higher cardiovascular risk following any alcohol consumption, but, by 24 hours, only heavy alcohol intake conferred continued risk.

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