Khawaja. A Ammar, MD¹, Saquib Samee, MD², Molly Shapiro, PhD¹, Richard. J Rodeheffer, MD², Ravindrakumar Makwana, MD¹, Robert Colligan, PhD³, and Robert Morse, MD⁴. (1) Internal Medicine, Olmsted Medical Center, 210 Ninth Street SE, Rochester, MN 55904, (2) Cardiovascular Diseases, The Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, 507-261-3274, sameemd1@hotmail.com, (3) Psychology, The Mayo Clinic, 200 First Street, SW, Rochester, MN 55904, (4) Psychiatry, 200 The Mayo Clinic, 200 First Street, SW, Rochester, MN 55901

Background: Due to medical, social and public health consequences of alcoholic behavior, there is a general reluctance in the medical community to recommend alcohol for cardiovascular (CV) benefit. We hypothesized that alcoholic drinking pattern would result from a higher number of drinks per day than non-alcoholic drinking pattern. Identification of a cutoff point in terms of number of drinks per day, beyond which one has a high risk of developing alcoholic behavior would help decrease the reluctance against alcohol prescription for CV benefit. Methods: In a randomly selected, population based sample of 2042 adults, age >= 45, the amount of alcohol consumed was assessed by a self-administered questionnaire. Self Administered Alcoholism Screening Test (SAAST), a validated questionnaire was used to identify alcoholic behavior. The cross-sectional rate of non-fatal MI was determined by systematic medical record review. Results: We identified 101 MI patients, 439 alcoholics, 1261 non-alcoholic drinkers and 166 abstainers. The prevalence of MI was the lowest in alcoholics (3.6%), higher in non-alcoholic drinkers (4%) and the highest in abstainers (12%) with p<0.0001. Odds ratio (CI) for MI were 0.4 (0.2,0.8) in alcoholics and 0.5 (0.4.0.8) in non-alcoholic drinkers, as compared to abstainers. Majority of alcoholics (78%) and nonalcoholic drinkers (71%) reported consuming <=2 drinks per day (p>0.05). Conclusion: There may be no safe cutoff point as the majority of both the alcoholics and non-alcoholics consume similar quantities, with in the CV benefit range, not withstanding the known tendency of alcoholics to underreport.

Learning Objectives:

• There is a general reluctance in the medical community to prescribe alcohol for prevention of vascular disease, despite well documented ability of alcohol to prevent MI. The main reason is the fear of recommending moderate alcohol intake and the patient getting carried away consuming too much and therefore becoming an alcoholic. Exactly how many drinks a day is associated with alcoholic behavior, has not been studied. Our objective was to see if the prevalence of alcoholism is acceptably low in less than 2 drinks a day. In such case, clinicians should feel safe in recommending alcohol for prevention. However, we found that most alcoholics and non-alcoholics consume alcohol in moderation (< or = 2 drinks per day). The learning point is that alcoholic behavior seems to be independent of excessive alcohol drinking. Therefore clinicians should continue to refrain from recommending alcohol intake to their patients. The cardiovascular benefits of alcohol are minor and do not justify the risk of alcoholism, which has personal (cardiac, GI, GU, CNS and endocrine) and societal (driving under influence leading to accidents) deleterious effects.

Keywords: Alcoholism, Myocardial Infarction

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.