Abstract
Background: Despite observations of an inverse association between moderate alcohol consumption and cardiovascular mortality, evidence for the effects of
alcohol consumption on atherosclerosis in randomized studies is lacking.
Purpose: To assess the effect of initiating moderate alcohol intake on progression of carotid atherosclerosis in alcohol-abstaining adults with well-controlled T2DM.
Methods: In the 2-year CASCADE (CArdiovaSCulAr Diabetes & Ethanol)
trial, patients were randomly assigned to 150mL of mineral-water, whitewine, or red-wine for 2 years. Wines and water were provided. All groups
followed a Mediterranean-diet without caloric restriction. Carotid-total-plaquevolume (carotid-TPV) and vessel-wall-volume (VWV), were assessed using threedimensional-ultrasound at baseline and after 2-years.
Results: Two-year repeated, high-quality, paired carotid images were available
from 174 participants (age = 59 years; 67% men; HbA1C=6.8%). Baseline detectable plaque was found in 55% of the participants. Mean TPV did not change
significantly in the entire cohort (mean change = −1.3 mm3±17.1), or in individual
intervention groups (red wine -1.31±17.6, white wine 1.17±16.9, mineral water
−1.38±17.0; p>0.05). However, in a post-hoc analysis of the 78 (45%) patients
who had detectable plaque at baseline, amongst participants in the top tertile
of baseline carotid TPV levels, wine consumption was associated with a greater
reduction in TPV (white-wine = −20.4 mm3 vs. water = −5.5 mm3, p=0.002, compared to baseline).
Data on VWV were available from 160 participants. After 2 years, no significant
changes were observed in VWV (619.7mm3 vs. 610.9mm3 after 2-years, p=0.09)
with no differences between intervention groups (p>0.05). Two-year changes in
systolic-blood-pressure remained an independent predictor of greater regression
in VWV (beta=0.187, p=0.029) adjusting for intervention-group, baseline VWV,
age, statin use and 2-year changes in BMI.
Conclusions: In a 2-year randomized study we were unable to detect a significant effect of wine consumption on carotid plaque volume or vessel wall volume in the entire group. The weak signal of greater TPV reduction by wine in those patients with highest baseline plaque volume should be further evaluated in larger randomized studies.
alcohol consumption on atherosclerosis in randomized studies is lacking.
Purpose: To assess the effect of initiating moderate alcohol intake on progression of carotid atherosclerosis in alcohol-abstaining adults with well-controlled T2DM.
Methods: In the 2-year CASCADE (CArdiovaSCulAr Diabetes & Ethanol)
trial, patients were randomly assigned to 150mL of mineral-water, whitewine, or red-wine for 2 years. Wines and water were provided. All groups
followed a Mediterranean-diet without caloric restriction. Carotid-total-plaquevolume (carotid-TPV) and vessel-wall-volume (VWV), were assessed using threedimensional-ultrasound at baseline and after 2-years.
Results: Two-year repeated, high-quality, paired carotid images were available
from 174 participants (age = 59 years; 67% men; HbA1C=6.8%). Baseline detectable plaque was found in 55% of the participants. Mean TPV did not change
significantly in the entire cohort (mean change = −1.3 mm3±17.1), or in individual
intervention groups (red wine -1.31±17.6, white wine 1.17±16.9, mineral water
−1.38±17.0; p>0.05). However, in a post-hoc analysis of the 78 (45%) patients
who had detectable plaque at baseline, amongst participants in the top tertile
of baseline carotid TPV levels, wine consumption was associated with a greater
reduction in TPV (white-wine = −20.4 mm3 vs. water = −5.5 mm3, p=0.002, compared to baseline).
Data on VWV were available from 160 participants. After 2 years, no significant
changes were observed in VWV (619.7mm3 vs. 610.9mm3 after 2-years, p=0.09)
with no differences between intervention groups (p>0.05). Two-year changes in
systolic-blood-pressure remained an independent predictor of greater regression
in VWV (beta=0.187, p=0.029) adjusting for intervention-group, baseline VWV,
age, statin use and 2-year changes in BMI.
Conclusions: In a 2-year randomized study we were unable to detect a significant effect of wine consumption on carotid plaque volume or vessel wall volume in the entire group. The weak signal of greater TPV reduction by wine in those patients with highest baseline plaque volume should be further evaluated in larger randomized studies.
| Original language | English |
|---|---|
| Pages (from-to) | 733-733 |
| Number of pages | 1 |
| Journal | European Heart Journal |
| Volume | 37 |
| Issue number | 1 |
| DOIs | |
| State | Published - 24 Aug 2016 |
