RELATIONSHIP BETWEEN MODERATE DRINKING WITH SYSTOLIC BLOOD PRESSURE AND IMPACT ON CARDIOVASCULAR OUTCOME IN KOREAN NATIONAL HEALTH INSURANCE SERVICE - NATIONAL SAMPLE COHORT (NHIS-NSC)

Abstract

Objective: The impact of moderate drinking on systolic blood pressure (SBP) and cardiovascular (CV) outcome is known to be as, so-called, J shaped relationship showing more beneficial than little drinking or than heavy drinking. In Korean study, there is some controversial data and the drinking may be confounded by socioeconomic status. The author analyzed the impact of moderate drinking on SBP and CV outcome.

Design and Method: In Korean National Health Insurance Service – National Sample Cohort (NHIS-NSC) established in 2002 and followed until 2010, 41104 subjects with the complete data for age, sex, BMI, fasting glucose, total cholesterol, family history of hypertension, cardiac disease and stroke history, physical activity, smoking, and drinking. Moderate drinking was defined as daily alcohol intake between 8∼20 gram per day. Primary composite end points were composite of acute myocardial infarction, stroke and cardiovascular death.

Results: Age was 46.6 ± 11.3 and female was 33.8% (n = 41104). Least square means ± standard error of SBPs were 124.4 ± 0.12, 125.3 ± 18.8, 126.7 ± 0.12, and 126.6 ± 0.26 mmHg for Q1 (<3 gram/day), Q2 (3∼8 gram/day), Q3 (8∼20 gram/day), and Q4 (>20 gram/day), respectively. There was no J shaped relationship in SBP and drinking. For cardiovascular outcomes, only Q3 showed statistically significant protective effect compared to no drinking (HR: 0.81, p = 0.0071 for 950 events) as well as age, smoking, house income (p = 0.037), sex, SBP, family history, and fasting glucose.

Conclusions: In NHIS-NSC data, drinking had positive linear relationship with SBP without J curve. And for cardiovascular outcomes, only moderate drinking showed beneficial effect suggesting J shaped relationship.