Researchers led by Gregory Marcus, M.D., of the University of California, San Francisco, analyzed a database of nearly 15 million California residents (aged 21 and older) who received ambulatory surgery, emergency care, or inpatient medical care in California between 2005 and 2009. The researchers then quantified the occurrences of alcohol abuse, cardiovascular outcomes, and other health data using International Classification of Diseases-9th Revision (ICD-9) and Current Procedural Terminology (CPT) codes given for each patient visit.
After adjusting for other potential risk factors, a diagnosis of alcohol abuse (identified in 268,084 patients, or 1.8%) was associated with a 2.14-fold increased risk of atrial fibrillation, a 1.45-fold increased risk of heart attack, and a 2.34-fold increased risk of congestive heart failure—magnitudes of risk that the authors noted are “similar to other well-established risk factors.”
They continued, “Although nearly all subgroups exhibited increased risk in the setting of alcohol abuse, those without a given risk factor for each outcome were disproportionately prone to enhanced cardiovascular risk.” However, while the relative risk of atrial fibrillation, heart attack, or heart failure rose significantly in this group, the absolute risk was still low.
“The authors are to be commended for carefully differentiating between the relative risk and absolute risk of alcohol abuse—both individually and in combination with other risk factors—as such differences have clinical implications,” wrote Michael Criqui, M.D, M.P.H, and Isac Thomas, M.D., of the University of California, San Diego, in an accompanying editorial.
Criqui and Thomas contrasted the findings by Marcus and colleagues with other research suggesting the health benefits of alcohol. Such studies, according to Criqui and Thomas, have tended to recruit more health-conscious participants and exclude heavy drinkers, so the results may be confounded by other lifestyle factors such as exercise and healthy eating.
“The current study likely presents a more valid picture of heavy drinking outcomes,” they wrote.
For related information, see the Psychiatric News article “Surgeon General Offers Next Steps for Tackling Substance Use.”