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Alcohol intake in middle age and risk of cardiovascular disease and mortality: accounting for intake variation over time.

Emberson, J. R., Shaper, A. G., Wannamethee, S. G., Morris, R. W., Whincup, P. H.·2005·American Journal of Epidemiology
DOI 10.1093/aje/kwi111
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Abstract

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.

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  • The study did not adjust alcohol and physical activity distributions for within-person variation because few prospective studies with multiple measurements provide reliable evidence for the relationship between one-off and usual exposure distributions.

    “We also did not adjust the distributions of alcohol use and physical activity, because there were very few prospective studies with multiple measurements to provide reliable evidence for the relationship between one-off and usual exposure distributions [9], [10].”

    From The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors (2009) · cites this paper as [10]

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Authors
Emberson, J. R., Shaper, A. G., Wannamethee, S. G., Morris, R. W., & Whincup, P. H.
Affiliations
  • The Royal Free Hospital (GB)
  • University of Bristol (GB)
Corresponding author
Emberson, J. R.
ORCID
Venue
American Journal of Epidemiology
Publisher
Oxford University Press (OUP)
Published
2005-05-01
Volume
161
Issue
9
Pages
856-863
ISSN
  • 0002-9262 (ISSN-L)
  • 1476-6256
DOI
10.1093/aje/kwi111
OpenAlex
W2152745698
Cited by
100
References
35
Citations by year
2023: 1 · 2022: 1 · 2021: 1 · 2019: 3 · 2018: 3 · 2017: 1 · 2016: 5 · 2015: 3 · 2014: 7 · 2013: 3 · 2012: 8
FWCI
7.35
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
  • Bristol Research (University of Bristol) (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
British Heart Foundation
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
alcohol consumption, cardiovascular disease, all-cause mortality, middle-aged men, heavy drinking, occasional drinking, non-drinkers, coronary events, stroke, U-shaped dose-response relationship, alcohol consumption limits
MeSH terms
Adult, Alcohol Drinking, Coronary Disease, Dose-Response Relationship, Drug, United Kingdom, Humans, Male, Middle Aged, Mortality, Prospective Studies, Surveys and Questionnaires, Risk Factors, Stroke

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