THE RELATION OF ALCOHOL CONSUMPTION WITH CARDIOVASCULAR DISEASES AND RISK FACTORS (ESSE-RF TRIAL IN KEMEROVSKAYA OBLAST)

Aim. To analyze the relation of alcohol consumption level with cardiovascular diseases and risk factors in the population of Kemerovskaya Oblast.

Material and methods. The study was performed under the framework of multicenter epidemiological trial ESSE-RF in Kemerovskaya Oblast, with 1628 participants with the age 25-64 y.o. The data was analyzed concerning the prevalence, volume and type of alcohol beverages by the respondents, as the prevalence of a range of cardiovascular diseases and risk factors. By original formulae, total volume was calculated of the consumed alcohol in units of the “safe” ethanol dose (24 grams) with further grouping to “non consuming” and consuming “moderately”, “in-between” and “over”.

Results. Overconsumption of alcohol, comparing to non-consumers, is associated with high risk of hypercholestrolemia (OR 1,76; 95% CI: 1,12-2,75), hypertriglyceridemia (OR 2,69: 1,52-4,77), body overweight (OR 1,68: 1,04-2,71), smoking (OR 2,24: 1,48-3,41). The relation of low physical activity with alcohol consumption is found in all grades. Increase of the mean daily ethanol dosage is positively linearly related with the risk of arterial hypertension (OR 1,04: 1,11-2,75), hypercholesterolemia (OR 1,06: 1,01-1,12), increased level of low density lipoproteins (OR 1,09: 1,02-1,16), smoking (OR 1,17: 1,10-1,24), low physical activity (OR 1,09: 1,02-1,16). There is U-shaped and upside-down J-shaped relation for the level of psychological risk factors (stress, anxiety, depression) and volumes of consumed alcohol. By the considered cardiovascular diseases it can be noted only, the existence of statistically non-significant (0,1>р>0,05) tendency to decrease myocardial infarction risk and stroke in anamnesis, with the increase of the consumed alcohol volumes comparing to non-drinkers.

Conclusion. The study shows that overconsumption of alcohol, as the increase of mean daily dosage of ethanol are associated with the range of cardiovascular risk factors. There is U-shaped and upside-down J-shaped relation of psychoemotional risk factors with the volumes of consumed alcohol. By the considered cardiovascular dseases, there are no significant relations for the level of consumed alcohol, however, there is non-significant tendency for myocardial infarction and stroke risk factors diminishing in the anamnesis, with the increase of consumed alcohol volumes.

1. Global status report on alcohol and health. WHO, 2014. http://www.who.int/substance_abuse/publications/global_alcohol_report/en/ (04 April 2017)

2. Hill JA. In vino veritas: alcohol and heart disease. Am J Med Sci. 2005; 329(3): 124–35.

3. McKee M, Britton A. The positive relationship between alcohol and heart disease in eastern Europe: potential physiological mechanisms. J Royal Soci Med 1998; 91(8): 402–7.

4. Leon DA, Shkolnikov VM, McKee M. et al. Alcohol increases circulatory disease mortality in Russia: acute and chronic effects or misattribution of cause? Int J Epidemiol 2010; 39: 1279–90.

5. Zhirov IV, Ogurcov PP. Arterial hypertension in case of abuse of ethanol. Voprosy Narkologii 2003; (6): 73–5. Russian (Жиров И. В., Огурцов П. П. Артериальная гипертензия при злоупотреблении этанолом. Вопросы наркологии 2003; (6): 73–75).

6. Komarova NA, Kalev OF. The relationship between hypertension, the status of alcohol consumption and depression as a result of epidemiological research. Problemy upravlenija zdorov'em 2007; (1): 61–4. Russian (Комарова Н. А., Калев О. Ф. Взаимосвязь между артериальной гипертензией, статусом потребления алкоголя и депрессией по результатам эпидемиологического исследования. Проблемы управления здоровьем 2007; (1): 61–4).

7. Wakabayashi I. Alcohol intake and triglycerides/High-Density Lipoprotein Cholesterol ratio in men with hypertension. Am J Hypertens 2013; 26: 888–95.

8. Bolormaa N, Igtatieva LP, Sodgerel B. Assessment of alcohol consumption and its’ relation to overweight among the adult population of Mongolia. Siberian Med J (Irkutsk) 2015; (5): 111–5. Russian (Болормаа Н., Игнатьева Л. П., Энхтуяа П. Оценка взаимосвязи избыточной массы тела и потребления алкоголя среди взрослого населения Монголии. Сибирский медицинский журнал (Иркутск) 2015; 5: 111–5).

9. Johnson KA, Jennison KM. The drinking-smoking syndrome and social context. Int J Addict 1992; 27(7): 749–92.

10. Katulanda P, Ranasinghe C, Rathnapala A. et al. Prevalence, patterns and correlates of alcohol consumption and its' association with tobacco smokingamong Sri Lankan adults: a cross-sectional study. BMC Public Health 2014; 14: 612.

11. Kopp M, Burtscher M, Kopp-Wilfling P. et al. Is there a link between physical activity and alcohol use? Subst Use Misuse 2015; 50(5): 546–51.

12. Leasure JL, Neighbors C. Impulsivity moderates the association between physical activity and alcohol consumption. Alcohol 2014; 48(4): 361–6.

13. Lisha NE, Martens M, Leventhal AM. Age and gender as moderators of the relationship between physical activity and alcohol use. Addict Behav 2011; 36(9): 933–6.

14. Sivolap YP, Savchenkov VA. Alcohol abuse and depression. Narcology 2012; 5: 79–82. Russian (Сиволап Ю. П., Савченков В. А. Злоупотребление алкоголем и депрессия. Наркология 2012; (5): 79–82).

15. Zav'jalov VJu. Motivation of alcohol consumption in patients with alcoholism and in healthy. Psihologicheskij zhurnal 1986; (5): 102–11. Russian (Завьялов В. Ю. Мотивация потребления алкоголя у больных алкоголизмом и у здоровых. Психологический журнал 1986; 5: 102–11).

16. Dawson DA, Grant BF, Ruan WJ. The association between stress and drinking: modifying effects of gender and vulnerability. Alcohol Alcohol 2005; 40(5): 453–60.

17. Rodgers B, Korten AE, Jorm AF et al. Non-linear relationships in associations of depression and anxiety with alcohol use. Psychol Med 2000; 30(2): 421–32.

18. Larsson SC, Wallin A, Wolk A. Contrasting association between alcohol consumption and risk of myocardial infarction and heart failure: Two prospective cohorts. Int J Cardiol 2017; 231: 207–10.

19. Gémes K, Janszky I, Laugsand LE et al. Alcohol consumption is associated with a lower incidence of acute myocardial infarction: results from a large prospective population-based study in Norway. J Intern Med 2016; 279(4): 365–75.

20. Ronksley PE, Brien SE, Turner BJ et al. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis // BMJ 2011; 342: d671.