A 30-year study of middle-aged Swedish men has found that alcohol consumption was associated with lower overall mortality, while beer consumption was linked to a higher risk of heart attack. However, the researchers stress that the findings do not prove that alcohol protects against death or that beer directly causes heart attacks.
The study, published in the Scandinavian Journal of Primary Health Care, examined the relationship between alcohol consumption, beverage type and the risks of myocardial infarction (MI), stroke and death from any cause.
Researchers analyzed data from the Coeur study, which began in 1993 and included 973 men aged 45 to 50 who worked for Volvo in Gothenburg, Sweden. Participants provided information about their alcohol consumption, smoking, physical activity, blood pressure, diabetes and other health and socioeconomic factors. Their health outcomes were tracked through national registers until the end of 2023.
During the 30-year follow-up, 237 participants died, 100 suffered a heart attack and 89 experienced a stroke.
The researchers found that men who consumed alcohol had lower overall mortality than those who reported no alcohol consumption. Wine and beer drinkers showed similar patterns. Kaplan-Meier analysis also estimated a longer average time to death among alcohol drinkers—28.1 years compared with 26.8 years for non-drinkers.
Wine drinkers had an estimated average time to death of 28.5 years, compared with 27.1 years among those who did not drink wine. For beer, the corresponding figures were 28.1 and 27.1 years.
The results for heart attacks were different. Overall alcohol consumption was not significantly associated with myocardial infarction. However, beer consumption was linked to a higher risk. About 12% of beer drinkers experienced a heart attack, compared with 7% of men who did not drink beer, corresponding to roughly 70% higher odds.
Beer drinkers also experienced heart attacks somewhat earlier during follow-up: the estimated mean time to the event was 28.5 years, compared with 29.1 years among non-beer drinkers.
The researchers found no significant relationship between alcohol consumption and stroke.
The study also showed that drinking groups differed in important ways from non-drinkers. Alcohol consumers were more likely to have higher HDL cholesterol levels and were more often married or employed in clerical positions. Such socioeconomic and lifestyle differences could have influenced the results.
The authors emphasize that the study was observational and therefore cannot establish cause and effect. The participants were exclusively middle-aged Swedish men with relatively stable employment, while alcohol consumption was based largely on self-reported information. Heavy drinkers were also underrepresented, and participants' lifestyles could have changed over the three decades.
The researchers conclude that the findings highlight the complex relationship between alcohol, beverage type and long-term health outcomes, rather than demonstrating that alcohol is beneficial. Larger studies involving more diverse populations and more detailed assessments of drinking habits and lifestyle factors are needed to clarify these associations.
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