Sex-Specific Fifteen-Year Alcohol Consumption Trajectories and Their Association with Cardiovascular Events and Mortality: The Framingham Heart Study.

Four distinct sex-specific alcohol consumption trajectories were identified among Framingham Heart Study participants over 15 years.

• Trajectories identified using a growth mixture model among 6570 participants (mean age 55 ± 13; 55% women) followed for 15 years
• Moderate-Decreasing group: 1179 women (0–14 g/day) and 1534 men (0–28 g/day) with declining moderate intake
• Low-to-None group: 992 women and 826 men who were light or non-drinkers
• Inverse-U group: 606 women and 199 men with variable intake over time
• High-Decreasing group: 858 women and 376 men with high initial consumption (women >14 g/day, men >28 g/day) that declined over time

Women in the Low-to-None, Inverse-U, and High-Decreasing trajectory groups had significantly higher CHD risks compared to the Moderate-Decreasing group.

• Hazard ratios for CHD ranged from 1.58 to 1.61 across the three non-moderate groups for women
• The Moderate-Decreasing group served as the reference group in Cox proportional hazards models
• Models adjusted for relevant covariates over 10 years of follow-up

Women in the Low-to-None and Inverse-U trajectory groups had significantly higher all-cause mortality risks compared to the Moderate-Decreasing group.

• Low-to-None group: HR 1.25 for all-cause mortality in women
• Inverse-U group: HR 1.28 for all-cause mortality in women
• The High-Decreasing group was not reported to have a statistically significant mortality difference for women in the abstract

Men in the Low-to-None trajectory group had higher all-cause mortality and CHD risk compared to the Moderate-Decreasing group.

• HR for all-cause mortality in men in Low-to-None group: 1.17
• HR for CHD in men in Low-to-None group: 1.60
• The High-Decreasing group showed the highest all-cause mortality risk among men (HR 1.27)

Men in the High-Decreasing trajectory group had the highest all-cause mortality risk among all male trajectory groups.

• HR for all-cause mortality in the High-Decreasing group for men: 1.27
• The High-Decreasing group had high initial consumption (>28 g/day for men) that declined over time
• This group comprised 376 men

The study found that low-to-moderate drinking was associated with lower mortality and CHD risks, but the authors explicitly caution against interpreting this as evidence of a protective effect of alcohol.

• Authors state: 'these findings do not confirm the protective effects of alcohol use'
• Authors caution 'against promoting moderate alcohol use as a strategy to reduce mortality risk or prevent CHD'
• The associations 'may not confirm causality' according to the authors
• The study emphasizes the importance of investigating long-term drinking patterns rather than snapshot measures

Sex differences were observed in the distribution of participants across alcohol consumption trajectory groups.

• The Inverse-U group was notably larger in women (606) than men (199)
• The High-Decreasing group was larger in women (858) than men (376)
• The Moderate-Decreasing group was larger in men (1534) than women (1179)
• Overall, 55% of the 6570 participants were women