Coronary Heart Disease Mortality and Alcohol Consumption in Framingham

The relationship between ethanol consumption and coronary heart disease was examined in the original Framingham Heart Study cohort (1948) with a 24-year follow-up from exam 2 (2,106 males and 2,639 females). Ethanol consumption shows a strong U-shaped relationship with coronary heart disease mortality for male nonsmokers and heavy smokers both in the raw age-adjusted data and in the Cox regression analyses, where ethanol consumption is modeled quadratically. No ethanol effects were found for female nonsmokers. The age-adjusted data suggest a U-shape curve for female smokers, although this was not confirmed by the Cox analysis. Separate analyses relating alcohol consumption to mortality from all causes showed similar effects except that the reduction in mortality for males was much less. For male coronary heart disease mortality, ethanol consumption was subdivided into beer, wine, and spirits consumption. These beverages were also modeled quadratically in the Cox analyses, and all showed strong U-shaped curves for both nonsmokers and heavy smokers. In nonsmokers, beer and wine show greater reductions in coronary heart disease mortality than spirits.