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Light-to-moderate alcohol consumption and mortality in the Physicians' Health Study enrollment cohort.

Abstract

OBJECTIVES

This study examined the relationship between light-to-moderate alcohol consumption and cause-specific mortality.

BACKGROUND

Previous studies suggest a J-shaped relation between alcohol and total mortality in men. A decrease in cardiovascular disease (CVD) mortality without a significant increase in other causes of mortality may explain the overall risk reduction at light-to-moderate levels.

METHODS

We conducted a prospective cohort study of 89,299 U.S. men from the Physicians' Health Study enrollment cohort who were 40 to 84 years old in 1982 and free of known myocardial infarction, stroke, cancer or liver disease at baseline. Usual alcohol consumption was estimated by a limited food frequency questionnaire.

RESULTS

There were 3,216 deaths over 5.5 years of follow-up. We observed a U-shaped relationship between alcohol consumption and total mortality. Compared with rarely/never drinkers, consumers of 1, 2 to 4 and 5 to 6 drinks per week and 1 drink per day had significant reductions in risk of death (multivariate relative risks [RRs] of 0.74, 0.77, 0.78 and 0.82, respectively) with no overall benefit or harm detected at the > or =2 drinks per day level (RR = 0.95; 95% confidence interval (CI), 0.79 to 1.14). The relationship with CVD mortality was inverse or L-shaped with apparent risk reductions even in the highest category of > or =2 drinks per day (RR = 0.76; 95% CI, 0.57 to 1.01). We found no clear harm or benefit for total or common site-specific cancers. For remaining other cancers, there was a nonsignificant 28% increased risk for those consuming > or =2 drinks per day.

CONCLUSIONS

These data support a U-shaped relation between alcohol and total mortality among light-to-moderate drinking men. The U-shaped curve may reflect an inverse association for CVD mortality, no association for common site-specific cancers and a possible positive association for less common cancers.

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  • Authors+Show Affiliations

    ,

    Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02215-1204, USA. gaziano@maveric.org

    , , , , , , ,

    Source

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Alcohol Drinking
    Cause of Death
    Cohort Studies
    Coronary Disease
    Follow-Up Studies
    Humans
    Male
    Middle Aged
    Myocardial Infarction
    Neoplasms
    Prospective Studies
    Risk
    Survival Analysis

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    10636266

    Citation

    Gaziano, J M., et al. "Light-to-moderate Alcohol Consumption and Mortality in the Physicians' Health Study Enrollment Cohort." Journal of the American College of Cardiology, vol. 35, no. 1, 2000, pp. 96-105.
    Gaziano JM, Gaziano TA, Glynn RJ, et al. Light-to-moderate alcohol consumption and mortality in the Physicians' Health Study enrollment cohort. J Am Coll Cardiol. 2000;35(1):96-105.
    Gaziano, J. M., Gaziano, T. A., Glynn, R. J., Sesso, H. D., Ajani, U. A., Stampfer, M. J., ... Buring, J. E. (2000). Light-to-moderate alcohol consumption and mortality in the Physicians' Health Study enrollment cohort. Journal of the American College of Cardiology, 35(1), pp. 96-105.
    Gaziano JM, et al. Light-to-moderate Alcohol Consumption and Mortality in the Physicians' Health Study Enrollment Cohort. J Am Coll Cardiol. 2000;35(1):96-105. PubMed PMID: 10636266.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Light-to-moderate alcohol consumption and mortality in the Physicians' Health Study enrollment cohort. AU - Gaziano,J M, AU - Gaziano,T A, AU - Glynn,R J, AU - Sesso,H D, AU - Ajani,U A, AU - Stampfer,M J, AU - Manson,J E, AU - Hennekens,C H, AU - Buring,J E, PY - 2000/1/15/pubmed PY - 2000/1/15/medline PY - 2000/1/15/entrez SP - 96 EP - 105 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 35 IS - 1 N2 - OBJECTIVES: This study examined the relationship between light-to-moderate alcohol consumption and cause-specific mortality. BACKGROUND: Previous studies suggest a J-shaped relation between alcohol and total mortality in men. A decrease in cardiovascular disease (CVD) mortality without a significant increase in other causes of mortality may explain the overall risk reduction at light-to-moderate levels. METHODS: We conducted a prospective cohort study of 89,299 U.S. men from the Physicians' Health Study enrollment cohort who were 40 to 84 years old in 1982 and free of known myocardial infarction, stroke, cancer or liver disease at baseline. Usual alcohol consumption was estimated by a limited food frequency questionnaire. RESULTS: There were 3,216 deaths over 5.5 years of follow-up. We observed a U-shaped relationship between alcohol consumption and total mortality. Compared with rarely/never drinkers, consumers of 1, 2 to 4 and 5 to 6 drinks per week and 1 drink per day had significant reductions in risk of death (multivariate relative risks [RRs] of 0.74, 0.77, 0.78 and 0.82, respectively) with no overall benefit or harm detected at the > or =2 drinks per day level (RR = 0.95; 95% confidence interval (CI), 0.79 to 1.14). The relationship with CVD mortality was inverse or L-shaped with apparent risk reductions even in the highest category of > or =2 drinks per day (RR = 0.76; 95% CI, 0.57 to 1.01). We found no clear harm or benefit for total or common site-specific cancers. For remaining other cancers, there was a nonsignificant 28% increased risk for those consuming > or =2 drinks per day. CONCLUSIONS: These data support a U-shaped relation between alcohol and total mortality among light-to-moderate drinking men. The U-shaped curve may reflect an inverse association for CVD mortality, no association for common site-specific cancers and a possible positive association for less common cancers. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/10636266/Light_to_moderate_alcohol_consumption_and_mortality_in_the_Physicians'_Health_Study_enrollment_cohort_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(99)00531-8 DB - PRIME DP - Unbound Medicine ER -