doi: 10.1161/hc3701.096067
(Circulation. 2001;104:1367.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Alcohol Consumption and Hemostatic Factors
Analysis of the Framingham Offspring Cohort
From the Divisions of General Medicine and Primary Care (K.J.M.) and Cardiology (P.P.J., M.A.M., I.L., T.M., D.L.), Beth Israel Deaconess Medical Center, Boston, Mass; the Department of Mathematics and Statistics (R.B.D., J.M.M., H.S.), Boston University, Boston, Mass; the Framingham Heart Study (P.A.S., D.L., P.W.F.W.), National Heart, Lung, and Blood Institute, Framingham, Mass; the Section of Preventive Medicine and Epidemiology (R.C.E.), Boston University School of Medicine, Boston, Mass; the Division of Cardiology (J.E.M.), Massachusetts General Hospital, Boston, Mass; and the Division of Cardiology (G.H.T.), Royal North Shore Hospital, Sydney, Australia.
Correspondence to Kenneth J. Mukamal, MD, MPH, MA, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Libby-303, Boston, MA 02215. E-mail kmukamal{at}caregroup.harvard.edu
Background—— Moderate alcohol consumers have lower rates of cardiovascular disease than abstainers. One proposed mechanism is a beneficial effect on hemostatic parameters, but previous studies have provided conflicting results.
Methods and Results—— We measured levels of fibrinogen, plasma viscosity, von Willebrand factor, factor VII, plasminogen activator inhibitor antigen-1, and tissue plasminogen activator antigen in a cross-sectional analysis of 3223 adults free of cardiovascular disease enrolled in the Framingham Offspring Study. We assessed their alcohol consumption with a standardized questionnaire. Light-to-moderate alcohol consumption was associated with lower levels of fibrinogen, plasma viscosity, von Willebrand factor, and factor VII. This association was most pronounced for consumers of 3 to 7 drinks weekly for viscosity and 7 to 21 drinks weekly for the other hemostatic measures. Alcohol intake of 7 to 21 drinks weekly or more was associated with impaired fibrinolytic potential, reflected by higher levels of plasminogen activator inhibitor antigen-1 and tissue plasminogen activator antigen. Wine drinkers had lower plasminogen activator inhibitor antigen-1 levels than other drinkers, particularly at 3 to 21 drinks weekly, but beverage type did not otherwise consistently affect the results.
Conclusions—— Light-to-moderate alcohol consumption is associated with lower levels of coagulatory factors, but higher intake is associated with impaired fibrinolytic potential. These findings are consistent with the hypothesis that a balance between hemostatic and fibrinolytic activity may contribute to the complex relation of alcohol use with coronary heart disease.
Key Words: alcohol • fibrinogen • fibrinolysis • thrombosis • plasminogin activators • von Willebrand factor
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