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February 9, 2000

Alcohol Consumption and Risk of Coronary Heart Disease

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(6):745-746. doi:10.1001/jama.283.6.741

To the Editor: The study by Dr Valmadrid and colleagues1 suggested that light to moderate alcohol intake is associated with a reduced risk of death from coronary heart disease (CHD) for persons with older-onset diabetes.

These results may not generalize to other populations. Only 1.5% of subjects in the study were nonwhite. This is relevant because blacks and South Asians with diabetes appear to have a worse prognosis, especially from CHD.2 Moreover, the socioeconomic status of the subjects was not known, an important factor because poverty (independently of ethnicity) is known to increase mortality from diabetes and other diseases.3 An indirect detrimental effect of generalizing the perceived benefits of alcohol consumption is based on the observation that some population groups that are relatively poor are often poorly educated and have alcohol-related problems. Examples include Asians in the United Kingdom, blacks and American Indians in the United States, and Australian Aborigines.4,5 How these groups would respond to a "safe limit" for alcohol consumption is uncertain, although the likely scenario is one of overindulgence, encouraged by an alcohol industry working behind the scenes.

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