Moderate alcohol consumption and risk for angina pectoris or myocardial infarction in US male physicians

Background: Although previous studies have found that moderate alcohol intake decreases the risk for myocardial infarction, many clinicians question the validity of this finding. Furthermore, the relation of moderate drinking to the risk for other events, such as angina pectoris, is not known, Objective: To determine whether moderate alcohol in take decreases the risk for angina pectoris or myocardial infarction in apparently healthy men. Design: Prospective cohort study. Setting: United States. Participants: 22 071 apparently healthy male physicians who were 40 to 84 years of age between 1981 and 1984. Measurements: Responses to annual questionnaires. Results: Through 1994, 1368 cases of new-onset angina and 690 cases of myocardial infarction had been documented. In multivariate analyses that controlled for several potential confounders, alcohol intake was strongly and inversely associated with the risk for each event (P for trend < 0.001). Compare with men who consumed less than one drink per week, those who consumed one drink per day had relative risks of 0.69 (95% CI, 0.59 to 0.81) for angina and 0.65 (CI, 0.52 to 0.81) for myocardial infarction. These associations were seen when either nondrinkers or occasional drinkers were used as the reference group. Conclusions: Moderate drinking decreases the risk for angina pectoris and myocardial infarction in apparently heal-thy men.