Alcohol intake in relation to non-fatal and fatal coronary heart disease and stroke: EPIC-CVD case-cohort study
Year: 2018
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To investigate the association between alcohol consumption (at baseline and over lifetime) and non-fatal and fatal coronary heart disease (CHD) and stroke. DESIGN: Multicentre case-cohort study. SETTING: A study of cardiovascular disease (CVD) determinants within the European Prospective Investigation into Cancer and nutrition cohort (EPIC-CVD) from eight European countries. PARTICIPANTS: 32 549 participants without baseline CVD, comprised of incident CVD cases and a subcohort for comparison. MAIN OUTCOME MEASURES: Non-fatal and fatal CHD and stroke (including ischaemic and haemorrhagic stroke). RESULTS: There were 9307 non-fatal CHD events, 1699 fatal CHD, 5855 non-fatal stroke, and 733 fatal stroke. Baseline alcohol intake was inversely associated with non-fatal CHD, with a hazard ratio of 0.94 (95% confidence interval 0.92 to 0.96) per 12 g/day higher intake. There was a J shaped association between baseline alcohol intake and risk of fatal CHD. The hazard ratios were 0.83 (0.70 to 0.98), 0.65 (0.53 to 0.81), and 0.82 (0.65 to 1.03) for categories 5.0-14.9 g/day, 15.0-29.9 g/day, and 30.0-59.9 g/day of total alcohol intake, respectively, compared with 0.1-4.9 g/day. In contrast, hazard ratios for non-fatal and fatal stroke risk were 1.04 (1.02 to 1.07), and 1.05 (0.98 to 1.13) per 12 g/day increase in baseline alcohol intake, respectively, including broadly similar findings for ischaemic and haemorrhagic stroke. Associations with cardiovascular outcomes were broadly similar with average lifetime alcohol consumption as for baseline alcohol intake, and across the eight countries studied. There was no strong evidence for interactions of alcohol consumption with smoking status on the risk of CVD events. CONCLUSIONS: Alcohol intake was inversely associated with non-fatal CHD risk but positively associated with the risk of different stroke subtypes. This highlights the opposing associations of alcohol intake with different CVD types and strengthens the evidence for policies to reduce alcohol consumption.
Source: BMJ
DOI: 10.1136/bmj.k934
Authors: Cristian Ricci, Angela Wood, David Muller, Marc J Gunter, Antonio Agudo, Heiner Boeing, Yvonne T van der Schouw, Samantha Warnakula, Calogero Saieva, Annemieke Spijkerman, Ivonne Sluijs, Anne Tjønneland, Cecilie Kyrø, Elisabete Weiderpass, Tilman Kühn, Rudolf Kaaks, Maria-Jose Sánchez, Salvatore Panico, Claudia Agnoli, Domenico Palli, Rosario Tumino, Gunnar Engström, Olle Melander, Fabrice Bonnet, Jolanda M A Boer, Timothy J Key, Ruth C Travis, Kim Overvad, W M Monique Verschuren, J Ramón Quirós, Antonia Trichopoulou, Eleni-Maria Papatesta, Eleni Peppa, Conchi Moreno Iribas, Diana Gavrila, Ann-Sofie Forslund, Jan-Håkan Jansson, Giuseppe Matullo, Larraitz Arriola, Heinz Freisling, Camille Lassale, Ioanna Tzoulaki, Stephen J Sharp, Nita G Forouhi, Claudia Langenberg, Rodolfo Saracci, Michael Sweeting, Paul Brennan, Adam S Butterworth, Elio Riboli, Nick J Wareham, John Danesh, Pietro Ferrari
Institutions: North-West University, Centre international de recherche sur le cancer, University of Cambridge, British Heart Foundation, Medical Research Council, Imperial College London, Institut Català d'Oncologia, German Institute of Human Nutrition, Utrecht University, University Medical Center Utrecht, National Institute for Public Health and the Environment, Danish Cancer Society, University of Helsinki, UiT The Arctic University of Norway, German Cancer Research Center, Universidad de Granada, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Andalusian School of Public Health, Federico II University Hospital, University of Naples Federico II, Fondazione IRCCS Istituto Nazionale dei Tumori, Lund University, Centre Hospitalier Universitaire de Rennes, University of Oxford, Aarhus University, Aalborg University Hospital, National and Kapodistrian University of Athens, Hellenic Health Foundation, Navarre Institute of Health Research, Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Instituto Murciano de Investigación Biosanitaria, Umeå University, Italian institute for Genomic Medicine, University of Turin, Basque Government, Biogipuzkoa Health Research Institute, University College London, University of Ioannina, MRC Epidemiology Unit
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Awards: Aetiology of type 2 diabetes and related metabolic disorders, Nutritional epidemiology, NIHR Senior Investigator Award, NIHR Senior Investigator Award, Large-scale integrative genomic studies of high-dimensional traits in cardiovascular diseases (renewal), G2826529823, G2892497062, G3803372573, G385907487, G4211044638, G4584873075, G4733990475, G567453067, EPIC-CVD: Individualised CVD risk assessment: tailoring targeted and cost-effective approaches to Europe's diverse populations, G6723261869, G6957823285, Interplay of genetic, nutrient and lifestyle factors on incidence of coronary disease: EPIC-Heart, Large-scale integrative studies of risk factors in coronary heart disease: from discovery to application (renewal). (Joint funding with MRC), G7939076303, G8254630708, NIHR Senior Investigator Award, NIHR Senior Investigator Award, G8946560635, Large-scale integrative studies of risk factors in coronary heart disease: from discovery to application
OpenAlex ID: W2805532368