FACTORS ASSOCIATED WITH CARDIAC MORTALITY IN DEVELOPED COUNTRIES WITH PARTICULAR REFERENCE TO THE CONSUMPTION OF WINE

doi:10.1016/S0140-6736(79)92765-X

The Lancet

Volume 313, Issue 8124, 12 May 1979, Pages 1017-1020

https://doi.org/10.1016/S0140-6736(79)92765-X Get rights and content

Abstract

Deaths from ischæmic heart-disease in 18 developed countries are not strongly associated with health-service factors such as doctor and nurse density. There is a negative association with gross national product per capita and a positive but inconsistent association with saturated and monounsaturated fat intake. The principal finding is a strong and specific negative association between ischæmic heart-disease deaths and alcohol consumption. This is shown to be wholly attributable to wine consumption.

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Citation Excerpt :
These include polyphenols lowering plasma concentrations of pro-oxidant and inflammatory molecules and leukocyte adhesion molecules, improving homeostasis model assessment of insulin resistance values and blood pressure, reducing phospholipids oxidation, modulating cell signaling pathways, reducing platelet aggregation,26-28 decreasing highly sensitive C-reactive protein, as well as concentrations of monocyte and endothelial adhesion molecules.29,30 St Leger et al31 reported a negative correlation between alcohol consumption and ischemic heart disease deaths, and attributed this observation predominantly to wine. Several explanations for the French paradox have been postulated,24 with epidemiologists presenting strong correlations in favor of wine (both white and red), with other scientific literature criticizing these observations.
Studies evaluating alcohol consumption and cardiovascular diseases have shown inconsistent results.
We performed a systematic review of peer-reviewed publications from an extensive query of Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception to March 2022 for all studies that reported the association between alcohol consumption in terms of quantity (daily or weekly amounts) and type of beverage (wine, beer or spirit) and cardiovascular disease events.
The study population included a total of 1,579,435 individuals based on 56 cohorts from several countries. We found that moderate wine consumption defined as 1-4 drinks per week was associated with a reduction in risk for cardiovascular mortality when compared with beer or spirits. However, higher risk for cardiovascular disease mortality was typically seen with heavier daily or weekly alcohol consumption across all types of beverages.
It is possible that the observational studies may overestimate the benefits of alcohol for cardiovascular disease outcomes. Although moderate wine consumption is probably associated with low cardiovascular disease events, there are many confounding factors, in particular, lifestyle, genetic, and socioeconomic associations with wine drinking, which likely explain much of the association with wine and reduced cardiovascular disease events. Further prospective study of alcohol and all-cause mortality, including cancer, is needed.
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L’histoire de l’épidémiologie, communément définie comme l’étude de la fréquence, de la distribution et des déterminants des pathologies dans les populations, est relativement récente. Née en Angleterre au XVII^e siècle, son histoire a été marquée par de nombreuses étapes aux XIX^e et au XX^e siècles. Initialement centrée sur la description des épidémies et des maladies transmissibles, l’épidémiologie moderne s’est focalisée sur l’étude des facteurs de risque des maladies chroniques et complexes en développant les méthodes d’enquête comme les études de cohorte et les études cas-témoins. L’objectivité et solidité des inférences est garantie par des analyses statistiques de plus en plus sophistiquées. L’apport des mathématiques et de la génétique (par exemple, la randomisation mendélienne) font de l’épidémiologie une branche scientifique de la médecine aujourd’hui incontournable, bien qu’elle ne soit enseignée que récemment. À l’origine de nombreuses hypothèses de travail, l’épidémiologie a permis d’élaborer des stratégies de santé publique et d’étayer des pratiques médicales factuelles.
The history of epidemiology, commonly defined as the study of the frequency, the distribution and the determinants of pathologies in defined populations is relatively recent. Started in England in the 18th century, its history has been marked by several stages in the 19th and 20th centuries. Initially focused on the description of epidemics and communicable diseases, modern epidemiology shifted to the study of risk factors for chronic and complex diseases by developing new survey methods such as cohort studies and case-control studies. The objectivity and solidity of inferences were guaranteed by increasingly sophisticated statistical analyses. The contribution of mathematics and genetics (such as Mendelian randomization) make epidemiology a mandatory scientific branch of medicine today, although it was taught only recently. At the origin of many working hypotheses, epidemiology has made it possible to develop public health strategies and to support evidence-based medical practices.
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Un corpus conséquent d’études observationnelles suggère que la consommation modérée et régulière de boissons alcoolisées a un effet cardioprotecteur, le vin ayant un avantage théorique en raison de sa teneur élevée en micronutriments. En fait, l’alcool semble être le composant cardioprotecteur le plus important, comme le confirment les effets bénéfiques rapportés avec la bière et, à un moindre degré, avec les autres boissons alcooliques. La manière de boire semble plus importante que la nature du breuvage.
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¹: Present address: Rhoose Farm House, Rhoose.

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Public HealthFACTORS ASSOCIATED WITH CARDIAC MORTALITY IN DEVELOPED COUNTRIES WITH PARTICULAR REFERENCE TO THE CONSUMPTION OF WINE

Abstract

Lancet

Lancet

Lancet

J. Epidemiol. common. Hlth

J. Soc. stat. Paris

Produktschap voor Gedistilleerde Dranken

Ischæmic Heart-Disease

Br. Heart J.

Public Health
FACTORS ASSOCIATED WITH CARDIAC MORTALITY IN DEVELOPED COUNTRIES WITH PARTICULAR REFERENCE TO THE CONSUMPTION OF WINE