Alcohol Consumption in Relation to Vascular and Total Mortality in Patients with Diabetes, Hypertension or History of Cardiovascular Disease: A Meta-analysis

Moderate alcohol consumption by apparently healthy people or patients with cardiovascular disease is associated with lower vascular and all-cause mortality. These findings were extended by two new meta-analyses aimed at assessing the relationship of alcohol drinking with vascular and total mortality in a large series of patients, including not only patients with a history of CVD but also diabetic and hypertensive patients. Two meta-analyses were performed: the first one considered 17 studies reporting secondary risk of vascular mortality; the second one included 14 studies reporting total mortality. The meta-analysis on vascular mortality and alcohol intake showed as an 'L-shaped' curve, indicating a protective effect (average 38%) that was maximal at about 40 and remained still significant up to 60 grams/day. J-shaped pooled curves were observed in the meta-analysis on mortality from any cause and in subgroups defined according to different types of patients or characteristics of the studies. While confirming the hazards of excess drinking, our findings indicate that in patients at high cardiovascular risk, low to moderate alcohol consumption is significantly associated with a reduced incidence of secondary non-fatal and/or fatal vascular events and all-cause mortality.