Background: We assessed the still unclear effect of the overall alcohol-drinking pattern,
beyond the amount of alcohol consumed, on the incidence of cardiovascular clinical disease (CVD).
Methods: We followed 14,651 participants during up to 14 years. We built a score assessing
simultaneously seven dimensions of alcohol consumption to capture the conformity to a traditional
Mediterranean alcohol-drinking pattern (MADP). It positively scored moderate alcohol intake,
alcohol intake spread out over the week, low spirit consumption, preference for wine, red wine
consumption, wine consumed during meals and avoidance of binge drinking. Results: During
142,177 person-years of follow-up, 127 incident cases of CVD (myocardial infarction, stroke or
cardiovascular mortality) were identified. Compared with the category of better conformity with
the MADP, the low-adherence group exhibited a non-significantly higher risk (HR) of total CVD
((95% CI) = 1.55 (0.58–4.16)). This direct association with a departure from the traditional MADP
was even stronger for cardiovascular mortality (HR (95% CI) = 3.35 (0.77–14.5)). Nevertheless, all
these associations were statistically non-significant. Conclusion: Better conformity with the MADP
seemed to be associated with lower cardiovascular risk in most point estimates; however, no
significant results were found and more powered studies are needed to clarify the role of the MADP
on CVD