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A statistically significant negative association between alcohol consumption and a subsequent first myocardial infarction in 464 patients was found in a study that was well controlled for cigarette smoking and five other established risk factors. There was a larger proportion of teetotalers among those who had a myocardial infarction (P < 0.01) as well as a smaller proportion of moderate (two or less drinks per day) and heavy (three or more drinks per day) consumers of alcoholic beverages. Alcohol consumption and cigarette smoking were strongly correlated habits. The lower consumption of alcohol by persons who subsequently had a myocardial infarction apparently was not the result of intake reduction because of known heart disease or risk-factor-related diseases such as hypertension and diabetes mellitus. Possible explanations include indirect association of drinking habits with ethnic origin, psychological traits or other unknown risk factors for myocardial infarction, or a protective effect of alcohol.
Klatsky et al. (Sun,) studied this question.