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Lifelong teetotallers, ex-drinkers and drinkers: mortality and the incidence of major coronary heart disease events in middle-aged British men.
Int J Epidemiol. 1997 Jun; 26(3):523-31.IJ

Abstract

BACKGROUND

To determine the risk of all cause mortality and the incidence of major coronary heart disease (CHD) events in lifelong teetotallers and in ex-drinkers compared with occasional and regular drinkers.

METHODS

A prospective study of middle-aged men drawn at random from one general practice in each of 24 British towns. Five years after the screening of 7735 men aged 40-59 years, 7167 provided further information on postal questionnaire enabling separation of non-drinkers into lifelong teetotallers and ex-drinkers.

RESULTS

During the follow-up period of 9.8 years after the postal questionnaire there were 929 deaths from all causes and 490 major CHD events. Ex-drinkers exhibited increased cardiovascular and non-cardiovascular mortality; lifelong teetotallers showed the lowest cardiovascular mortality but a significantly increased non-cardiovascular mortality. After adjustment for confounding factors and pre-existing disease, the two non-drinking groups did not differ significantly in all cause mortality from occasional and regular drinkers (light, moderate or heavy) but lifelong teetotallers still showed a significant increase in non-cardiovascular mortality. Adjustment considerably attenuated the risk of both cardiovascular and non-cardiovascular mortality in the ex-drinkers. In men without a diagnosis of CHD, lifelong teetotallers and ex-drinkers showed similar increased relative risk (RR) of heart attacks, with regular drinkers (combined) having a significantly decreased risk compared to occasional drinkers (RR = 0.78, 95% confidence interval [CI] : 0.64-0.96) and non-drinkers (RR = 0.69, 95% CI : 0.52-0.91). This decreased risk was small in absolute terms at around 2-3 major CHD events/1000 person-years.

CONCLUSIONS

Lifelong teetotallers and ex-drinkers showed a significantly increased RR of major CHD events compared with regular drinkers, although this risk is small in absolute terms. Lifelong teetotallers have a low risk of overall cardiovascular mortality and an increased risk of non-cardiovascular mortality. Non-drinkers constitute an unsuitable reference group in alcohol-related studies; occasional or even light drinkers may be more appropriate. Overall, there is no convincing evidence that light or moderate drinking has a protective effect on total or cardiovascular mortality in these middle-aged British men.

Authors+Show Affiliations

Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London, UK.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9222777

Citation

Wannamethee, S G., and A G. Shaper. "Lifelong Teetotallers, Ex-drinkers and Drinkers: Mortality and the Incidence of Major Coronary Heart Disease Events in Middle-aged British Men." International Journal of Epidemiology, vol. 26, no. 3, 1997, pp. 523-31.
Wannamethee SG, Shaper AG. Lifelong teetotallers, ex-drinkers and drinkers: mortality and the incidence of major coronary heart disease events in middle-aged British men. Int J Epidemiol. 1997;26(3):523-31.
Wannamethee, S. G., & Shaper, A. G. (1997). Lifelong teetotallers, ex-drinkers and drinkers: mortality and the incidence of major coronary heart disease events in middle-aged British men. International Journal of Epidemiology, 26(3), 523-31.
Wannamethee SG, Shaper AG. Lifelong Teetotallers, Ex-drinkers and Drinkers: Mortality and the Incidence of Major Coronary Heart Disease Events in Middle-aged British Men. Int J Epidemiol. 1997;26(3):523-31. PubMed PMID: 9222777.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lifelong teetotallers, ex-drinkers and drinkers: mortality and the incidence of major coronary heart disease events in middle-aged British men. AU - Wannamethee,S G, AU - Shaper,A G, PY - 1997/6/1/pubmed PY - 1997/6/1/medline PY - 1997/6/1/entrez KW - Alcohol Drinking KW - Behavior KW - Biology KW - Causes Of Death--men KW - Comparative Studies KW - Demographic Factors KW - Developed Countries KW - Differential Mortality KW - Diseases KW - Europe KW - Heart Diseases KW - Mortality KW - Northern Europe KW - Population KW - Population Dynamics KW - Research Methodology KW - Risk Factors KW - Risk Reduction Behavior KW - Studies KW - United Kingdom SP - 523 EP - 31 JF - International journal of epidemiology JO - Int J Epidemiol VL - 26 IS - 3 N2 - BACKGROUND: To determine the risk of all cause mortality and the incidence of major coronary heart disease (CHD) events in lifelong teetotallers and in ex-drinkers compared with occasional and regular drinkers. METHODS: A prospective study of middle-aged men drawn at random from one general practice in each of 24 British towns. Five years after the screening of 7735 men aged 40-59 years, 7167 provided further information on postal questionnaire enabling separation of non-drinkers into lifelong teetotallers and ex-drinkers. RESULTS: During the follow-up period of 9.8 years after the postal questionnaire there were 929 deaths from all causes and 490 major CHD events. Ex-drinkers exhibited increased cardiovascular and non-cardiovascular mortality; lifelong teetotallers showed the lowest cardiovascular mortality but a significantly increased non-cardiovascular mortality. After adjustment for confounding factors and pre-existing disease, the two non-drinking groups did not differ significantly in all cause mortality from occasional and regular drinkers (light, moderate or heavy) but lifelong teetotallers still showed a significant increase in non-cardiovascular mortality. Adjustment considerably attenuated the risk of both cardiovascular and non-cardiovascular mortality in the ex-drinkers. In men without a diagnosis of CHD, lifelong teetotallers and ex-drinkers showed similar increased relative risk (RR) of heart attacks, with regular drinkers (combined) having a significantly decreased risk compared to occasional drinkers (RR = 0.78, 95% confidence interval [CI] : 0.64-0.96) and non-drinkers (RR = 0.69, 95% CI : 0.52-0.91). This decreased risk was small in absolute terms at around 2-3 major CHD events/1000 person-years. CONCLUSIONS: Lifelong teetotallers and ex-drinkers showed a significantly increased RR of major CHD events compared with regular drinkers, although this risk is small in absolute terms. Lifelong teetotallers have a low risk of overall cardiovascular mortality and an increased risk of non-cardiovascular mortality. Non-drinkers constitute an unsuitable reference group in alcohol-related studies; occasional or even light drinkers may be more appropriate. Overall, there is no convincing evidence that light or moderate drinking has a protective effect on total or cardiovascular mortality in these middle-aged British men. SN - 0300-5771 UR - https://www.unboundmedicine.com/medline/citation/9222777/Lifelong_teetotallers_ex_drinkers_and_drinkers:_mortality_and_the_incidence_of_major_coronary_heart_disease_events_in_middle_aged_British_men_ L2 - https://academic.oup.com/ije/article-lookup/doi/10.1093/ije/26.3.523 DB - PRIME DP - Unbound Medicine ER -