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Lower alcohol consumption reduces risk for mortality
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Adults who drank about 100 g of alcohol per week had the lowest risk for all-cause mortality compared with other amounts, according to an analysis published in The Lancet.
Studies of current drinkers
Angela M. Wood, PhD, university lecturer in biostatistics in the department of public health and primary care at the University of Cambridge in the United Kingdom, and colleagues analyzed data from 83 prospective studies that recorded risk factors, quantified alcohol consumption and determined CVD events and cause-specific death in 599,912 participants who currently drank alcohol. Participants did not have a history of CVD at baseline. Data were obtained from the Emerging Risk Factors Collaboration, EPIC-CVD and UK Biobank.
Alcohol consumption was categorized by the amount in grams that were consumed per week. Participants were followed up until the first outcome was recorded for a median of 7.5 years or 5.4 million person-years.
During follow-up, 40,310 participants died and 39,018 participants had a first CVD incident.
There was a positive and curvilinear association with alcohol consumption and all-cause mortality. The lowest risk for all-cause mortality was seen in participants who consumed less than 100 g of alcohol per week.
After adjusting for sex, age, history of diabetes and smoking, the amount of alcohol consumed had a positive and generally linear association with coronary disease excluding MI (HR per 100 g per week higher consumption = 1.06; 95% CI, 1-1.11), stroke (HR per 100 g per week higher consumption = 1.14; 95% CI, 1.1-1.17), fatal hypertensive disease (HR per 100 g per week higher consumption = 1.24; 95% CI, 1.15-1.33), HF (HR per 100 g per week higher consumption = 1.09; 95% CI, 1.03-1.15) and fatal aortic aneurysm (HR per 100 g per week higher consumption = 1.15; 95% CI, 1.03-1.28). Alcohol consumption had an inverse and approximately log-linear association with MI (HR per 100 g per week higher consumption = 0.94; 95% CI, 0.91-0.97).
Reduced life expectancy
A shorter life expectancy at age 40 years was seen in participants who drank less than 100 g per week (6 months), those who drank between 100 g and 200 g per week (1 to 2 years) and participants who drank between 200 g and 350 g per week (4 to 5 years).
“Both blood pressure and HDL-C are known to increase in response to alcohol consumption,” Wood and colleagues wrote. “They have contrasting associations with cardiovascular disease outcomes: The inverse association of HDL-C with cardiovascular disease is substantially stronger for coronary disease than stroke, whereas the positive association of systolic blood with cardiovascular disease is considerably stronger for stroke than coronary disease. However, we did not find convincing evidence that other known risk factors were important mediators or confounders.”
In a related editorial, Jason Connor, director of the Centre for Youth Substance Abuse and professor at the Princess Alexandra Hospital Southside Clinical Unit at University of Queensland in Australia, and Wayne Hall, professor at the Centre for Youth Substance Abuse at University of Queensland, wrote: “The drinking levels recommended in this study will no doubt be described as implausible and impracticable by the alcohol industry and other opponents of public health warnings on alcohol. Nonetheless, the findings ought to be widely disseminated and they should provoke informed public and professional debate.” – by Darlene Dobkowski
Disclosures: Wood, Connor and Hall report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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