The latest critique from The ISFAR looks at a study that relates alcohol intake to the development of abdominal aortic aneurysm

The latest critique from The ISFAR looks at a study that relates alcohol intake to the development of abdominal aortic aneurysm

The large majority of prospective epidemiologic studies on the effects of alcohol consumption and the risk of coronary heart disease and stroke have shown a significant reduction in risk for moderate drinkers.

There have been few studies relating alcohol intake to the development of abdominal aortic aneurysm (AAA), and results have been inconsistent. A recent study is based on two very large, population-based cohorts in Sweden that were followed prospectively for the clinical development of AAA (identified by radiography, surgical repair or death resulting from rupture).

There were more than 1,200 cases identified during a 14-year follow-up period. The results of the study suggest that moderate drinking is associated with a lower risk of AAA, with the beneficial effects primarily among consumers of beer or wine.

Forum reviewers were unanimous in considering this to be a well-done analysis, with unbiased estimates of the effect of alcohol on the risk of aneurysm. The reduced risk of AAA among moderate drinkers was similar to that seen for common manifestations of atherosclerosis, especially coronary heart disease and ischemic stroke.

Reviewers were uncertain why only consumers of wine and beer showed a beneficial effect, but not consumers of spirits: This could be explained by the polyphenols present in wine and, to a less extent, in beer that have been shown to be anti-inflammatory, anti-oxidant, and anti-platelet aggregation (all mechanisms that may relate to the development of AAA). However, residual confounding could also play a role. 

It was noted that the percentage of the population with hypertension, probably the most important risk factor for AAA, was much lower than is common in most industrialised countries, but the degree to which this affected the results cannot be known. While alcohol is known to increase blood pressure, some large studies suggest that an increase occurs only with more than light-to-moderate drinking. Further, there were few very heavy drinkers (the highest category of alcohol was an average consumption of =1 drink/day among women and =2 drinks/day among men), so this study could not assess whether or not large amounts of alcohol might increase risk of AAA.

There have been a very limited number of studies on alcohol intake and aortic aneurysm. While this study suggests a slight decrease in occurrence of AAA with moderate wine and beer intake, it will be important for other large studies to evaluate this association.

Additional studies on polyphenol intake and occurrence of AAA will also be useful.

To read the full critique, click here.

These critiques are published with the permission of The ISFAR.