PURPOSE: Limited data suggest that moderate alcohol drinkers may be at lower risk of COPD than abstainers. Important potential confounders are smoking, concomitant coronary artery disease (CAD), and inclusion of former drinkers among abstainers. With more data needed, we performed a cohort study in a large multiethnic population.
METHODS: We studied 126,263 men and women who supplied baseline data at 1978–85 health examinations. Through 2004 a subsequent primary hospitalization diagnosis of COPD (ICD-9 codes 491–6, except 493) was made in 760 persons. COPD risk was estimated by Cox proportional hazards models including age, sex, ethnicity, education, smoking, body mass index, and 7 alcohol intake categories. Some models included a yes vs. no composite CAD risk/symptoms covariate.
RESULTS: With lifelong abstainers as referent, adjusted relative risks (RR), 95 % confidence intervals (CI) for COPD were: exdrinkers = 1.29 (0.95–1.74), < 1 drink/day = 0.83 (0.68–1.01), 1–2 dr/day = 0.76 (0.61–0.94, p = 0.01), 3–5 dr/day = 0.85 (0.65–1.12), and > 6 dr/day = 1.52 (1.04–2.24, p = 0.03). This alcohol-COPD J-curve was present in whites, African-Americans, ex-smokers, light smokers, heavy smokers, younger and older persons, and in subjects with either chronic bronchitis or other COPD diagnoses. However, the apparent benefit at moderate drinking levels was concentrated in women and subjects free of CAD history/symptoms. E.g., comparing persons reporting 1–2 drinks per day vs. lifelong abstainers, the RR (CI)'s were: men = 0.9 (0.7–1.3), women = 0.7 (0.5–0.9), CAD composite “yes” = 1.2 (0.6–2.5), and CAD composite “no” = 0.4 (0.1–1.1). Frequent wine drinking, both of red and white wine, was independently related to lower COPD risk. Covariate relations to COPD risk were as expected, with higher risk for older persons, men, smokers, and persons with low educational level.
CONCLUSION: These data show that, independent of smoking and CAD, moderate alcohol drinkers are at lower risk than lifelong abstainers of hospitalization for COPD.
CLINICAL IMPLICATIONS: Drinking moderate amounts of alcoholic beverages may have benefit for COPD.
DISCLOSURE: Stanton Siu, None.