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Alcohol and Congestive Heart Failure
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IN RESPONSE:
Dr. Dong raises interesting questions about the influence of genetic variation in alcohol metabolism on the association between alcohol consumption and risk for congestive heart failure. Polymorphisms of the ADH2 and ALDH2 genes are relatively uncommon in populations of white ethnicity (1) and are therefore unlikely to substantially affect the association between alcohol consumption and congestive heart failure in our study, which was conducted in a largely white sample. Caution is warranted in extrapolating our findings to nonwhite populations in which polymorphisms of ADH2 and ALDH2 are common.
As Dr. Dong correctly points out, genetic polymorphisms of the ADH3 gene, which are present in 40% to 50% of white persons, are associated with risk for myocardial infarction (2). The protective effects of the slow-metabolizing ADH3 polymorphism against myocardial infarction are, in part, mediated through beneficial effects on high-density lipoprotein cholesterol levels (2). Whether drinkers who are homozygous for the slow-metabolizing ADH3 polymorphism are protected against congestive heart failure due to coronary heart disease deserves further investigation.
Craig R. Walsh, MD
Daniel Levy, MD
Framingham Heart Study; Framingham, MA 01702
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
