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February 9, 2000

Alcohol Consumption and Risk of Coronary Heart Disease—Reply

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

In Reply: We agree that generalizing the results from our study to other diabetic population groups or settings for which we have no data (eg, developing countries and other racial groups) is inappropriate.

Socioeconomic status may be an important confounder for the association between alcohol consumption and CHD mortality. Even after adjusting for education, the association remained, as we reported in our article. We also subsequently examined personal income and family income; these variables, like education, were found to be directly associated with alcohol intake and inversely associated with CHD mortality (ie, people with higher incomes tended to drink more and to have a lowered risk of subsequent mortality from CHD). However, even after adjusting for income levels, the significant relationship of alcohol intake with CHD mortality remained. Furthermore, in the presence of alcohol intake in our multivariate models, income levels were not found to be independently related to CHD mortality in our cohort. Likewise, adjusting for income levels did not materially change the associations with all-cause mortality. Nonetheless, we are aware that controlling for these measures in our cohort would not adequately address the question regarding the true role of socioeconomic factors in the alcohol-CHD mortality relationship in other populations (eg, in developing countries).

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