TY - JOUR
T1 - Alcohol intake in relation to non-fatal and fatal coronary heart disease and stroke
T2 - EPIC-CVD case-cohort study
AU - Ricci, Cristian
AU - Wood, Angela
AU - Muller, David
AU - Gunter, Marc J.
AU - Agudo, Antonio
AU - Boeing, Heiner
AU - Van Der Schouw, Yvonne T.
AU - Warnakula, Samantha
AU - Saieva, Calogero
AU - Spijkerman, Annemieke
AU - Sluijs, Ivonne
AU - Tjønneland, Anne
AU - Kyrø, Cecilie
AU - Weiderpass, Elisabete
AU - Kühn, Tilman
AU - Kaaks, Rudolf
AU - Sánchez, Maria Jose
AU - Panico, Salvatore
AU - Agnoli, Claudia
AU - Palli, Domenico
AU - Tumino, Rosario
AU - Engström, Gunnar
AU - Melander, Olle
AU - Bonnet, Fabrice
AU - Boer, Jolanda M.A.
AU - Key, Timothy J.
AU - Travis, Ruth C.
AU - Overvad, Kim
AU - Verschuren, W. M.Monique
AU - Quirós, J. Ramón
AU - Trichopoulou, Antonia
AU - Papatesta, Eleni Maria
AU - Peppa, Eleni
AU - Iribas, Conchi Moreno
AU - Gavrila, Diana
AU - Forslund, Ann Sofie
AU - Jansson, Jan Håkan
AU - Matullo, Giuseppe
AU - Arriola, Larraitz
AU - Freisling, Heinz
AU - Lassale, Camille
AU - Tzoulaki, Ioanna
AU - Sharp, Stephen J.
AU - Forouhi, Nita G.
AU - Langenberg, Claudia
AU - Saracci, Rodolfo
AU - Sweeting, Michael
AU - Brennan, Paul
AU - Butterworth, Adam S.
AU - Riboli, Elio
AU - Wareham, Nick J.
AU - Danesh, John
AU - Ferrari, Pietro
N1 - Publisher Copyright:
© 2018 Published by the BMJ Publishing Group Limited.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85047630651&partnerID=8YFLogxK
U2 - 10.1136/bmj.k934
DO - 10.1136/bmj.k934
M3 - Article
C2 - 29844013
SN - 1756-1833
VL - 361
JO - BMJ - Clinical research
JF - BMJ - Clinical research
M1 - k934
ER -