Prospective study of alcohol drinking patterns and coronary heart disease in women and men

Objective: To determine the association between alcohol drinking patterns and risk of coronary heart disease in women and men. Design: Population based cohort study. Setting: Denmark, 1993-2002. Participants: 28 448 women and 25 052 men aged 50-65 years, who were free of cardiovascular disease at entry to the study. Main outcome measures: Incidence of coronary heart disease occurring during a median follow-up period of 5.7 years. Results: 749 and 1283 coronary heart disease events occurred among women and men. Women who drank alcohol on at least one day a week had a lower risk of coronary heart disease than women who drank alcohol on less than one day a week. Little difference was found, however, between drinking frequency: one day a week (hazard ratio 0.64, 95% confidence interval 0.51 to 0.81), 2-4 days a week (0.63, 0.52 to 0.77), five or six days a week (0.79, 0.61 to 1.03), and seven days a week (0.65, 0.51 to 0.84). For men an inverse association was found between drinking frequency and risk of coronary heart disease across the entire range of drinking frequencies. The lowest risk was observed among men who drank daily (0.59, 0.48 to 0.71) compared with men who drank alcohol on less than one day a week. Conclusions: Among women alcohol intake may be the primary determinant of the inverse association between drinking alcohol and risk of coronary heart disease whereas among men, drinking frequency, not alcohol intake, seems more important.