A burden of proof study on alcohol consumption and ischemic heart disease

Sinclair Carr (), Dana Bryazka, Susan A. McLaughlin, Peng Zheng, Sarasvati Bahadursingh, Aleksandr Y. Aravkin, Simon I. Hay, Hilary R. Lawlor, Erin C. Mullany, Christopher J. L. Murray, Sneha I. Nicholson, Jürgen Rehm, Gregory A. Roth, Reed J. D. Sorensen, Sarah Lewington and Emmanuela Gakidou
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Sinclair Carr: University of Washington
Dana Bryazka: University of Washington
Susan A. McLaughlin: University of Washington
Peng Zheng: University of Washington
Sarasvati Bahadursingh: University of Oxford
Aleksandr Y. Aravkin: University of Washington
Simon I. Hay: University of Washington
Hilary R. Lawlor: University of Washington
Erin C. Mullany: University of Washington
Christopher J. L. Murray: University of Washington
Sneha I. Nicholson: University of Washington
Jürgen Rehm: Institute for Mental Health Policy Research, Centre for Addiction and Mental Health
Gregory A. Roth: University of Washington
Reed J. D. Sorensen: University of Washington
Sarah Lewington: University of Oxford
Emmanuela Gakidou: University of Washington

Nature Communications, 2024, vol. 15, issue 1, 1-16

Abstract: Abstract Cohort and case-control data have suggested an association between low to moderate alcohol consumption and decreased risk of ischemic heart disease (IHD), yet results from Mendelian randomization (MR) studies designed to reduce bias have shown either no or a harmful association. Here we conducted an updated systematic review and re-evaluated existing cohort, case-control, and MR data using the burden of proof meta-analytical framework. Cohort and case-control data show low to moderate alcohol consumption is associated with decreased IHD risk – specifically, intake is inversely related to IHD and myocardial infarction morbidity in both sexes and IHD mortality in males – while pooled MR data show no association, confirming that self-reported versus genetically predicted alcohol use data yield conflicting findings about the alcohol-IHD relationship. Our results highlight the need to advance MR methodologies and emulate randomized trials using large observational databases to obtain more definitive answers to this critical public health question.

Date: 2024
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DOI: 10.1038/s41467-024-47632-7

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