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Objective  First, to investigate and compare associations between alcohol consumption and variants in alcohol dehydrogenase (ADH) genes with incidence of cardiovascular diseases (CVD) in a large German cohort. Second, to quantitatively summarize available evidence of prospective studies on polymorphisms in  ADH1B  and  ADH1C  and CVD-risk.    Methods  We conducted a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort including a randomly drawn subcohort (n = 2175) and incident cases of myocardial infarction (MI; n = 230) or stroke (n = 208). Mean follow-up time was 8.2±2.2 years. The association between alcohol consumption,  ADH1B  or  ADH1C  genotypes, and CVD-risk was assessed using Cox proportional hazards regression. Additionally, we report results on associations of variants in  ADH1B  and  ADH1C  with ischemic heart disease and stroke in the context of a meta-analysis of previously published prospective studies published up to November 2011.    Results  Compared to individuals who drank >0 to 6 g alcohol/d, we observed a reduced risk of MI among females consuming >12 g alcohol/d (HR = 0.31; 95% CI: 0.10–0.97) and among males consuming >24 to 60 g/d (HR = 0.57; 95% CI: 0.33–0.98) or >60 g alcohol/d (HR = 0.30; 95% CI: 0.12–0.78). Stroke risk was not significantly related to alcohol consumption >6 g/d, but we observed an increased risk of stroke in men reporting no alcohol consumption. Individuals with the slow-coding  ADH1B*1/1  genotype reported higher median alcohol consumption. Yet, polymorphisms in  ADH1B  or  ADH1C  were not significantly associated with risk of CVD in our data and after pooling results of eligible prospective studies [ ADH1B*1/1 : RR = 1.35 (95% CI: 0.98–1.88; p for heterogeneity: 0.364);  ADH1C*2/2 : RR = 1.07 (95% CI: 0.90–1.27; p for heterogeneity: 0.098)].    Conclusion  The well described association between alcohol consumption and CVD-risk is not reflected by ADH polymorphisms, which modify the rate of ethanol oxidation.

Alcohol Consumption, Genetic Variants in Alcohol Deydrogenases, and Risk of Cardiovascular Diseases: A Prospective Study and Meta-Analysis