A burden of proof study on alcohol consumption and ischemic heart disease.
Sinclair CarrDana BryazkaSusan A McLaughlinPeng ZhengSarasvati BahadursinghAleksandr Y AravkinSimon I HayHilary R LawlorErin C MullanyChristopher J L MurraySneha I NicholsonJürgen RehmGregory A RothReed J D SorensenSarah LewingtonEmmanuela GakidouPublished in: Nature communications (2024)
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.
Keyphrases
- alcohol consumption
- case control
- electronic health record
- systematic review
- public health
- big data
- magnetic resonance
- contrast enhanced
- randomized controlled trial
- risk factors
- magnetic resonance imaging
- high intensity
- squamous cell carcinoma
- data analysis
- clinical trial
- computed tomography
- radiation therapy
- artificial intelligence
- cardiovascular disease
- coronary artery disease
- machine learning
- left ventricular
- locally advanced
- weight loss
- global health
- weight gain
- open label