Men in Belfast, Northern Ireland--a city where heavy drinking on weekends is common--were far more likely to suffer cardiovascular events than Frenchmen, whose overall alcohol intake may be higher but is spread evenly throughout the week, researchers said.
The prospective study of almost 10,000 middle-age men found that those in Belfast were 76 percent more likely to experience a heart attack or coronary death than Frenchmen of the same age after adjusting for traditional cardiovascular risk factors. The increased risk fell by half when drinking status was added to the adjustments.
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Findings from the two-nation study bolster previous evidence that binge drinking is particularly unhealthy, Dr. Jean-Bernard Ruidavets of Toulouse University in France and colleagues reported online in BMJ.
"Regular and moderate alcohol intake throughout the week, the typical pattern in middle aged men in France, is associated with a low risk of ischemic heart disease, whereas the binge drinking pattern more prevalent in Belfast confers a higher risk," Ruidavets and co-authors wrote.
The researchers indicated that the results are worrisome because binge drinking is on the rise in countries such as France and Spain, particularly among young people.
"The alcohol industry takes every opportunity to imbue alcohol consumption with a positive image, emphasising its beneficial effects on risk of ischemic heart disease, but people also need to be informed about the health consequences of heavy drinking," they wrote.
The study drew on data from the Prospective Epidemiological Study of Myocardial Infarction, or PRIME, which has followed 2,405 middle-age men in Belfast and 7,373 in three French cities (Toulouse, Lille, and Strasbourg) starting in the early 1990s. The men were ages 50 to 59 and free of ischemic heart disease at baseline.
Ruidavets and colleagues examined rates of cardiovascular events during 10 years of follow-up in these two cultures with very different drinking patterns.
Some 90 percent of the French participants reported current alcohol consumption, compared with 60 percent of the Belfast men.
At the same time, binge drinking was reported by 9 percent of participants in Belfast but by only 0.5 percent of the Frenchmen. The Belfast bingers had a mean weekly ethanol intake of 4 oz whereas the steady drinkers in France averaged 8 oz weekly.
MI and coronary death struck 5.3 percent of Belfast participants and 2.6 percent of the Frenchmen during follow-up. There was little difference between the three French centers.
Rates were higher in Belfast than in France for every level of average alcohol consumption. Among Frenchmen drinking nearly 3 oz daily, 2.9 percent suffered cardiac events, which was the highest rate among French drinkers.
In contrast, the lowest event rate seen in Belfast men of 3.8 percent was seen both in the heaviest and the lightest drinkers.
Ruidavets and colleagues did not report event rates stratified both by country and drinking pattern (i.e., periodic bingeing versus steady daily intake). However, they did calculate hazard ratios for weekend bingers, lifetime abstainers, and former drinkers relative to steady drinkers in the two countries.