ORIGINAL CONTRIBUTIONS |
Alcohol Intake in Middle Age and Risk of Cardiovascular Disease and Mortality: Accounting for Intake Variation over Time
1 Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, United Kingdom
2 Department of Community Health Sciences, St. George's Hospital Medical School, London, United Kingdom
Correspondence to J. R. Emberson, Clinical Trial Service Unit, Harkness Building, Radcliffe Infirmary, Oxford OX2 6HE, United Kingdom (e-mail: jonathan.emberson{at}ctsu.ox.ac.uk).
Moderate alcohol consumption is associated with a decreased risk of cardiovascular disease. However, the impact of variation in alcohol intake over time on estimated risk relations has not been adequately addressed. In this study, 6,544 middle-aged British men without previous cardiovascular disease were followed for cardiovascular events and all-cause mortality over 20 years from 1978/1980 to 1998/2000. Alcohol intake was ascertained at regular points throughout the study. A total of 922 men had a major coronary event within 20 years, 352 men had a stroke, and 1,552 men died of all causes. Baseline alcohol intake displayed U-shaped relations with cardiovascular disease and all-cause mortality, with light drinkers having the lowest risks and nondrinkers and heavy drinkers having similarly high risks. However, the nature of these relations changed after adjustment for intake variation; risks associated with nondrinking were lowered, and risks associated with moderate and heavy drinking increased. Regular heavy drinkers had a 74% higher risk of a major coronary event, a 133% higher risk of stroke, and a 127% higher risk of all-cause mortality than did occasional drinkers (these estimates were 8%, 54%, and 44% before adjustment for intake variation). The findings suggest that considerable caution may be needed before any recommendations regarding acceptable limits of alcohol consumption are made.
alcohol drinking; cerebrovascular accident; coronary disease; mortality
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