Alcohol consumption, types of alcoholic beverages and risk of venous thromboembolism – The Tromsø Study
Received: 28 January 2011
Accepted after major revision: 03 May 2011
25 November 2017 (online)
Moderate alcohol consumption has been shown to protect against cardiovascular diseases. The association between alcohol consumption, especially types of alcoholic beverages, and venous thromboembolism (VTE) is less well described. The aim of this study was to investigate the impact of alcohol consumption and different alcoholic beverages on risk of VTE. Information on alcohol consumption was collected by a selfadministrated questionnaire in 26,662 subjects, aged 25–97 years, who participated in the Tromsø Study, in 1994–1995. Subjects were followed through September 1, 2007 with incident VTE as the primary outcome. There were 460 incident VTE-events during a median of 12.5 years of follow-up. Total alcohol consumption was not associated with risk of incident VTE. However, subjects consuming ≥3 units of liquor per week had 53% increased risk of VTE compared to teetotalers in analyses adjusted for age, sex, body mass index, smoking, diabetes, cancer, previous cardiovascular disease, physical activity and higher education (HR: 1.53, 95% CI: 1.00–2.33). Contrary, subjects with a wine intake of ≥3 units/week had 22% reduced risk of VTE (HR: 0.78, 95% CI: 0.47–1.30), further adjustment for liquor and beer intake strengthened the protective effect of wine (HR: 0.53, 95% CI: 0.30–1.00). Frequent binge drinkers (≥1/week) had a 17% increased risk of VTE compared to teetotallers (HR 1.17, 95% CI: 0.66–2.09), and a 47% increased risk compared to non-binge drinkers (HR 1.47, 95% CI: 0.85–2.54). In conclusion, liquor consumption and binge drinking was associated with increased risk of VTE, whereas wine consumption was possibly associated with reduced risk of VTE.
- 1 Heit JA. Venous thromboembolism: disease burden, outcomes and risk factors. J Thromb Haemost 2005; 3: 1611-1617.
- 2 Kahn SR, Shbaklo H, Lamping DL. et al. Determinants of health-related quality of life during the 2 years following deep vein thrombosis. J Thromb Haemost 2008; 6: 1105-1112.
- 3 Silverstein MD, Heit JA, Mohr DN. et al. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 1998; 158: 585-593.
- 4 Glynn RJ, Rosner B. Comparison of risk factors for the competing risks of coronary heart disease, stroke, and venous thromboembolism. Am J Epidemiol 2005; 162: 975-982.
- 5 White RH. The epidemiology of venous thromboembolism. Circulation 2003; 107: I4-8.
- 6 World Health Organization. World Health Organization Global Status Report on alcohol. 2004 Avaliable at: http://www.who.int/substance_abuse/publications/global_status_report_2004_overview.pdf . Accessed May 15, 2010.
- 7 Pace-Asciak CR, Hahn S, Diamandis EP. et al. The red wine phenolics trans-resveratrol and quercetin block human platelet aggregation and eicosanoid synthesis: implications for protection against coronary heart disease. Clin Chim Acta 1995; 235: 207-219.
- 8 Yarnell JW, Sweetnam PM, Rumley A. et al. Lifestyle and hemostatic risk factors for ischemic heart disease : the Caerphilly Study. Arterioscler Thromb Vasc Biol 2000; 20: 271-279.
- 9 Dimmitt SB, Rakic V, Puddey IB. et al. The effects of alcohol on coagulation and fibrinolytic factors: a controlled trial. Blood Coagul Fibrinolysis 1998; 9: 39-45.
- 10 Mukamal KJ, Jadhav PP, D’Agostino RB. et al. Alcohol consumption and hemostatic factors: analysis of the Framingham Offspring cohort. Circulation 2001; 104: 1367-1373.
- 11 Hvidtfeldt UA, Tolstrup JS, Jakobsen MU. et al. Alcohol Intake and Risk of Coronary Heart Disease in Younger, Middle-Aged, and Older Adults. Circulation 2010; 121: 1589-1597.
- 12 Mukamal KJ, Chen CM, Rao SR. et al. Alcohol consumption and cardiovascular mortality among U.S. adults, 1987 to 2002. J Am Coll Cardiol 2010; 55: 1328-1335.
- 13 Pahor M, Guralnik JM, Havlik RJ. et al. Alcohol consumption and risk of deep venous thrombosis and pulmonary embolism in older persons. J Am Geriatr Soc 1996; 44: 1030-1037.
- 14 Lutsey PL, Steffen LM, Virnig BA. et al. Diet and incident venous thromboembolism: the Iowa Women’s Health Study. Am Heart J 2009; 157: 1081-1087.
- 15 Lindqvist PG, Epstein E, Olsson H. The relationship between lifestyle factors and venous thromboembolism among women: a report from the MISS study. Br J Haematol 2009; 144: 234-240.
- 16 Pomp ER, Rosendaal FR, Doggen CJ. Alcohol consumption is associated with a decreased risk of venous thrombosis. Thromb Haemost 2008; 99: 59-63.
- 17 Tsai AW, Cushman M, Rosamond WD. et al. Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiology. Arch Intern Med 2002; 162: 1182-1189.
- 18 Samama MM. An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the Sirius study. Arch Intern Med 2000; 160: 3415-3420.
- 19 Braekkan SK, Mathiesen EB, Njolstad I. et al. Mean platelet volume is a risk factor for venous thromboembolism: the Tromso Study, Tromso, Norway. J Thromb Haemost 2010; 8: 157-162.
- 20 Djousse L, Ellison RC, Beiser A. et al. Alcohol consumption and risk of ischemic stroke: The Framingham Study. Stroke 2002; 33: 907-912.
- 21 Friedman LA, Kimball AW. Coronary heart disease mortality and alcohol consumption in Framingham. Am J Epidemiol 1986; 124: 481-489.
- 22 Pendurthi UR, Williams JT, Rao LV. Resveratrol, a polyphenolic compound found in wine, inhibits tissue factor expression in vascular cells : A possible mechanism for the cardiovascular benefits associated with moderate consumption of wine. Arterioscler Thromb Vasc Biol 1999; 19: 419-426.
- 23 Gryglewski RJ, Korbut R, Robak J. et al. On the mechanism of antithrombotic action of flavonoids. Biochem Pharmacol 1987; 36: 317-322.
- 24 Klatsky AL. Alcohol and cardiovascular health. Physiol Behav 2010; 100: 76-81.
- 25 Pieters M, Vorster HH, Jerling JC. et al. The effect of ethanol and its metabolism on fibrinolysis. Thromb Haemost 2010; 104: 724-733.
- 26 Mortensen EL, Jensen HH, Sanders SA. et al. Better psychological functioning and higher social status may largely explain the apparent health benefits of wine: a study of wine and beer drinking in young Danish adults. Arch Intern Med 2001; 161: 1844-1848.
- 27 Barefoot JC, Gronbaek M, Feaganes JR. et al. Alcoholic beverage preference, diet, and health habits in the UNC Alumni Heart Study. Am J Clin Nutr 2002; 76: 466-472.
- 28 Horverak Ø, Bye EK. The Norwegian drinking pattern. A study based on analyses of survey data from 1973-2004. Avaliable at: http://sirus.no/The+Norwegian+drinking+pattern.E2x322-8_Bp77BFv3TR9D6CJ1KWCUwlVPL28nMhPLZB9MtlY05hRDIX3.ips Accessed March 3, 2011.
- 29 Statistics Norway. Statistics on alcohol sales, by type of beverage. Avaliable at: http://statbank.ssb.no/statistikkbanken/Default_FRasp?PXSid=0&nvl=true&PLanguage=1&tilside=selectvarval/define.asp&Tabellid=04188. Accessed March 3, 2011.
- 30 Ruidavets JB, Bataille V, Dallongeville J. et al. Alcohol intake and diet in France, the prominent role of lifestyle. Eur Heart J 2004; 25: 1153-1162.
- 31 Khani BR, Ye W, Terry P. et al. Reproducibility and validity of major dietary patterns among Swedish women assessed with a food-frequency questionnaire. J Nutr 2004; 134: 1541-1545.