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This study examined associations between reductions in WHO risk drinking levels and subsequent risk for CVD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a US national survey, 1,058 very\u2010high\u2010risk and high\u2010risk drinkers participated in Wave 1 interviews (2001 to 2002) and Wave 2 follow\u2010ups (2004 to 2005). Self\u2010reported CVD history that was communicated to the participant by a doctor or other healthcare professionals included arteriosclerosis, hypertension, angina, tachycardia, or myocardial infarction. We used logistic regression to estimate adjusted odds ratios (aOR) evaluating relationships between \u22652\u2010level reductions in WHO risk drinking levels from Wave 1 to Wave 2 and the risk of Wave 2 CVD, controlling for baseline characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Reductions of \u22652 WHO risk drinking levels were associated with significantly lower odds of CVD in individuals who at Wave 1 were very\u2010high\u2010risk (aOR\u00a0=\u00a00.58 [0.41 to 0.80]) or high\u2010risk drinkers (aOR\u00a0=\u00a00.81 [0.70 to 0.94]). Interaction terms showed that this relationship varied by age. Among individuals &gt;40\u00a0years old at Wave 1, reductions of \u22652 WHO risk drinking levels were associated with significantly lower odds of CVD among very\u2010high\u2010risk drinkers (aOR\u00a0=\u00a00.42 [0.28 to 0.63]) but not high\u2010risk drinkers (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.50). Among individuals \u226440\u00a0years old at Wave 1, reductions of \u22652 WHO risk drinking levels were associated with significantly lower odds of CVD among high\u2010risk drinkers (aOR\u00a0=\u00a00.50 [0.37 to 0.69]) but not very\u2010high\u2010risk drinkers (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.27).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These results show that reductions in WHO risk drinking levels are associated with reduced CVD risk among very\u2010high\u2010risk and high\u2010risk drinkers in the US general population, and provide further evidence that reducing high levels of drinking provides important benefit across multiple clinical domains.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14386","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T17:30:36Z","timestamp":1593797436000},"page":"1625-1635","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Reduction in World Health Organization Risk Drinking Levels and Cardiovascular Disease"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6771-8138","authenticated-orcid":false,"given":"Justin","family":"Knox","sequence":"first","affiliation":[{"name":"Columbia University Mailman School of Public Health New York New York"},{"name":"New York State Psychiatric Institute New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Scodes","sequence":"additional","affiliation":[{"name":"New York State Psychiatric Institute New York New 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