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Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study

Summary Background Alcohol consumption is proposed to be the third most important modifiable risk factor for death and disability. However, alcohol consumption has been associated with both benefits and harms, and previous studies were mostly done in high-income countries. We investigated associatio... Full description

Journal Title: The Lancet (British edition) 2015, Vol.386 (10007), p.1945-1954
Main Author: Smyth, Andrew, Dr
Other Authors: Teo, Koon K, Prof , Rangarajan, Sumathy, MSc , O'Donnell, Martin, PhD , Zhang, Xiaohe, MSc , Rana, Punam, MD , Leong, Darryl P, PhD , Dagenais, Gilles, Prof , Seron, Pamela, MSc , Rosengren, Annika, Prof , Schutte, Aletta E, Prof , Lopez-Jaramillo, Patricio, Prof , Oguz, Ayetkin, Prof , Chifamba, Jephat, MPhil , Diaz, Rafael, MD , Lear, Scott, Prof , Avezum, Alvaro, PhD , Kumar, Rajesh, MD , Mohan, Viswanathan, MD , Szuba, Andrzej, Prof , Wei, Li, PhD , Yang, Wang, MD , Jian, Bo, BSc , McKee, Martin, Prof , Yusuf, Salim, Prof
Format: Electronic Article Electronic Article
Language: English
Subjects:
Abridged Index Medicus
Admission and discharge
Adult
Aged
Alcohol Drinking - epidemiology
Alcohol use
Alcoholic beverages
Alcohols
Analysis
Blood pressure
Canada
Cancer
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cerebral infarction
Cohort Studies
Consumption
Developed Countries
Developing Countries
Drinking behavior
Drinking of alcoholic beverages
Epidemiology
Female
Hazard identification
Health aspects
Health hazards
Health risk assessment
Heart attack
Heart attacks
Hospitalization
Hospitalization - statistics & numerical data
Hospitals
Humans
Hypertension
Income
India
Injuries
Internal Medicine
Male
Middle Aged
Mortality
Myocardial infarction
Neoplasms - epidemiology
Oncology, Experimental
Pharmaceuticals
Proportional Hazards Models
Public health
Risk analysis
Risk factors
Smoking
Stroke
Variables
Womens health
Wounds and Injuries - epidemiology
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
Link: https://www.ncbi.nlm.nih.gov/pubmed/26386538
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recordid: cdi_proquest_miscellaneous_1762961960
title: Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study
format: Article
creator:
  • Smyth, Andrew, Dr
  • Teo, Koon K, Prof
  • Rangarajan, Sumathy, MSc
  • O'Donnell, Martin, PhD
  • Zhang, Xiaohe, MSc
  • Rana, Punam, MD
  • Leong, Darryl P, PhD
  • Dagenais, Gilles, Prof
  • Seron, Pamela, MSc
  • Rosengren, Annika, Prof
  • Schutte, Aletta E, Prof
  • Lopez-Jaramillo, Patricio, Prof
  • Oguz, Ayetkin, Prof
  • Chifamba, Jephat, MPhil
  • Diaz, Rafael, MD
  • Lear, Scott, Prof
  • Avezum, Alvaro, PhD
  • Kumar, Rajesh, MD
  • Mohan, Viswanathan, MD
  • Szuba, Andrzej, Prof
  • Wei, Li, PhD
  • Yang, Wang, MD
  • Jian, Bo, BSc
  • McKee, Martin, Prof
  • Yusuf, Salim, Prof
subjects:
  • Abridged Index Medicus
  • Admission and discharge
  • Adult
  • Aged
  • Alcohol Drinking - epidemiology
  • Alcohol use
  • Alcoholic beverages
  • Alcohols
  • Analysis
  • Blood pressure
  • Canada
  • Cancer
  • Cardiovascular disease
  • Cardiovascular diseases
  • Cardiovascular Diseases - epidemiology
  • Cerebral infarction
  • Cohort Studies
  • Consumption
  • Developed Countries
  • Developing Countries
  • Drinking behavior
  • Drinking of alcoholic beverages
  • Epidemiology
  • Female
  • Hazard identification
  • Health aspects
  • Health hazards
  • Health risk assessment
  • Heart attack
  • Heart attacks
  • Hospitalization
  • Hospitalization - statistics & numerical data
  • Hospitals
  • Humans
  • Hypertension
  • Income
  • India
  • Injuries
  • Internal Medicine
  • Male
  • Middle Aged
  • Mortality
  • Myocardial infarction
  • Neoplasms - epidemiology
  • Oncology, Experimental
  • Pharmaceuticals
  • Proportional Hazards Models
  • Public health
  • Risk analysis
  • Risk factors
  • Smoking
  • Stroke
  • Variables
  • Womens health
  • Wounds and Injuries - epidemiology
ispartof: The Lancet (British edition), 2015, Vol.386 (10007), p.1945-1954
description: Summary Background Alcohol consumption is proposed to be the third most important modifiable risk factor for death and disability. However, alcohol consumption has been associated with both benefits and harms, and previous studies were mostly done in high-income countries. We investigated associations between alcohol consumption and outcomes in a prospective cohort of countries at different economic levels in five continents. Methods We included information from 12 countries participating in the Prospective Urban Rural Epidemiological (PURE) study, a prospective cohort study of individuals aged 35–70 years. We used Cox proportional hazards regression to study associations with mortality (n=2723), cardiovascular disease (n=2742), myocardial infarction (n=979), stroke (n=817), alcohol-related cancer (n=764), injury (n=824), admission to hospital (n=8786), and for a composite of these outcomes (n=11 963). Findings We included 114 970 adults, of whom 12 904 (11%) were from high-income countries (HICs), 24 408 (21%) were from upper-middle-income countries (UMICs), 48 845 (43%) were from lower-middle-income countries (LMICs), and 28 813 (25%) were from low-income countries (LICs). Median follow-up was 4·3 years (IQR 3·0–6·0). Current drinking was reported by 36 030 (31%) individuals, and was associated with reduced myocardial infarction (hazard ratio [HR] 0·76 [95% CI 0·63–0·93]), but increased alcohol-related cancers (HR 1·51 [1·22–1·89]) and injury (HR 1·29 [1·04–1·61]). High intake was associated with increased mortality (HR 1·31 [1·04–1·66]). Compared with never drinkers, we identified significantly reduced hazards for the composite outcome for current drinkers in HICs and UMICs (HR 0·84 [0·77–0·92]), but not in LMICs and LICs, for which we identified no reductions in this outcome (HR 1·07 [0·95–1·21]; pinteraction
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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titleAlcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study
sourceAlma/SFX Local Collection
creatorSmyth, Andrew, Dr ; Teo, Koon K, Prof ; Rangarajan, Sumathy, MSc ; O'Donnell, Martin, PhD ; Zhang, Xiaohe, MSc ; Rana, Punam, MD ; Leong, Darryl P, PhD ; Dagenais, Gilles, Prof ; Seron, Pamela, MSc ; Rosengren, Annika, Prof ; Schutte, Aletta E, Prof ; Lopez-Jaramillo, Patricio, Prof ; Oguz, Ayetkin, Prof ; Chifamba, Jephat, MPhil ; Diaz, Rafael, MD ; Lear, Scott, Prof ; Avezum, Alvaro, PhD ; Kumar, Rajesh, MD ; Mohan, Viswanathan, MD ; Szuba, Andrzej, Prof ; Wei, Li, PhD ; Yang, Wang, MD ; Jian, Bo, BSc ; McKee, Martin, Prof ; Yusuf, Salim, Prof
creatorcontribSmyth, Andrew, Dr ; Teo, Koon K, Prof ; Rangarajan, Sumathy, MSc ; O'Donnell, Martin, PhD ; Zhang, Xiaohe, MSc ; Rana, Punam, MD ; Leong, Darryl P, PhD ; Dagenais, Gilles, Prof ; Seron, Pamela, MSc ; Rosengren, Annika, Prof ; Schutte, Aletta E, Prof ; Lopez-Jaramillo, Patricio, Prof ; Oguz, Ayetkin, Prof ; Chifamba, Jephat, MPhil ; Diaz, Rafael, MD ; Lear, Scott, Prof ; Avezum, Alvaro, PhD ; Kumar, Rajesh, MD ; Mohan, Viswanathan, MD ; Szuba, Andrzej, Prof ; Wei, Li, PhD ; Yang, Wang, MD ; Jian, Bo, BSc ; McKee, Martin, Prof ; Yusuf, Salim, Prof ; PURE Investigators
descriptionSummary Background Alcohol consumption is proposed to be the third most important modifiable risk factor for death and disability. However, alcohol consumption has been associated with both benefits and harms, and previous studies were mostly done in high-income countries. We investigated associations between alcohol consumption and outcomes in a prospective cohort of countries at different economic levels in five continents. Methods We included information from 12 countries participating in the Prospective Urban Rural Epidemiological (PURE) study, a prospective cohort study of individuals aged 35–70 years. We used Cox proportional hazards regression to study associations with mortality (n=2723), cardiovascular disease (n=2742), myocardial infarction (n=979), stroke (n=817), alcohol-related cancer (n=764), injury (n=824), admission to hospital (n=8786), and for a composite of these outcomes (n=11 963). Findings We included 114 970 adults, of whom 12 904 (11%) were from high-income countries (HICs), 24 408 (21%) were from upper-middle-income countries (UMICs), 48 845 (43%) were from lower-middle-income countries (LMICs), and 28 813 (25%) were from low-income countries (LICs). Median follow-up was 4·3 years (IQR 3·0–6·0). Current drinking was reported by 36 030 (31%) individuals, and was associated with reduced myocardial infarction (hazard ratio [HR] 0·76 [95% CI 0·63–0·93]), but increased alcohol-related cancers (HR 1·51 [1·22–1·89]) and injury (HR 1·29 [1·04–1·61]). High intake was associated with increased mortality (HR 1·31 [1·04–1·66]). Compared with never drinkers, we identified significantly reduced hazards for the composite outcome for current drinkers in HICs and UMICs (HR 0·84 [0·77–0·92]), but not in LMICs and LICs, for which we identified no reductions in this outcome (HR 1·07 [0·95–1·21]; pinteraction <0·0001). Interpretation Current alcohol consumption had differing associations by clinical outcome, and differing associations by income region. However, we identified sufficient commonalities to support global health strategies and national initiatives to reduce harmful alcohol use. Funding Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, GlaxoSmithKline, Novartis, King Pharma, and national or local organisations in participating countries.
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0ISSN: 0140-6736
1EISSN: 1474-547X
2DOI: 10.1016/S0140-6736(15)00235-4
3PMID: 26386538
4CODEN: LANCAO
languageeng
publisherEngland: Elsevier Ltd
subjectAbridged Index Medicus ; Admission and discharge ; Adult ; Aged ; Alcohol Drinking - epidemiology ; Alcohol use ; Alcoholic beverages ; Alcohols ; Analysis ; Blood pressure ; Canada ; Cancer ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cerebral infarction ; Cohort Studies ; Consumption ; Developed Countries ; Developing Countries ; Drinking behavior ; Drinking of alcoholic beverages ; Epidemiology ; Female ; Hazard identification ; Health aspects ; Health hazards ; Health risk assessment ; Heart attack ; Heart attacks ; Hospitalization ; Hospitalization - statistics & numerical data ; Hospitals ; Humans ; Hypertension ; Income ; India ; Injuries ; Internal Medicine ; Male ; Middle Aged ; Mortality ; Myocardial infarction ; Neoplasms - epidemiology ; Oncology, Experimental ; Pharmaceuticals ; Proportional Hazards Models ; Public health ; Risk analysis ; Risk factors ; Smoking ; Stroke ; Variables ; Womens health ; Wounds and Injuries - epidemiology
ispartofThe Lancet (British edition), 2015, Vol.386 (10007), p.1945-1954
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3COPYRIGHT 2015 Elsevier B.V.
4Copyright Elsevier Limited Nov 14, 2015
52015. Elsevier Ltd
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0Smyth, Andrew, Dr
1Teo, Koon K, Prof
2Rangarajan, Sumathy, MSc
3O'Donnell, Martin, PhD
4Zhang, Xiaohe, MSc
5Rana, Punam, MD
6Leong, Darryl P, PhD
7Dagenais, Gilles, Prof
8Seron, Pamela, MSc
9Rosengren, Annika, Prof
10Schutte, Aletta E, Prof
11Lopez-Jaramillo, Patricio, Prof
12Oguz, Ayetkin, Prof
13Chifamba, Jephat, MPhil
14Diaz, Rafael, MD
15Lear, Scott, Prof
16Avezum, Alvaro, PhD
17Kumar, Rajesh, MD
18Mohan, Viswanathan, MD
19Szuba, Andrzej, Prof
20Wei, Li, PhD
21Yang, Wang, MD
22Jian, Bo, BSc
23McKee, Martin, Prof
24Yusuf, Salim, Prof
25PURE Investigators
title
0Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study
1The Lancet (British edition)
addtitleLancet
descriptionSummary Background Alcohol consumption is proposed to be the third most important modifiable risk factor for death and disability. However, alcohol consumption has been associated with both benefits and harms, and previous studies were mostly done in high-income countries. We investigated associations between alcohol consumption and outcomes in a prospective cohort of countries at different economic levels in five continents. Methods We included information from 12 countries participating in the Prospective Urban Rural Epidemiological (PURE) study, a prospective cohort study of individuals aged 35–70 years. We used Cox proportional hazards regression to study associations with mortality (n=2723), cardiovascular disease (n=2742), myocardial infarction (n=979), stroke (n=817), alcohol-related cancer (n=764), injury (n=824), admission to hospital (n=8786), and for a composite of these outcomes (n=11 963). Findings We included 114 970 adults, of whom 12 904 (11%) were from high-income countries (HICs), 24 408 (21%) were from upper-middle-income countries (UMICs), 48 845 (43%) were from lower-middle-income countries (LMICs), and 28 813 (25%) were from low-income countries (LICs). Median follow-up was 4·3 years (IQR 3·0–6·0). Current drinking was reported by 36 030 (31%) individuals, and was associated with reduced myocardial infarction (hazard ratio [HR] 0·76 [95% CI 0·63–0·93]), but increased alcohol-related cancers (HR 1·51 [1·22–1·89]) and injury (HR 1·29 [1·04–1·61]). High intake was associated with increased mortality (HR 1·31 [1·04–1·66]). Compared with never drinkers, we identified significantly reduced hazards for the composite outcome for current drinkers in HICs and UMICs (HR 0·84 [0·77–0·92]), but not in LMICs and LICs, for which we identified no reductions in this outcome (HR 1·07 [0·95–1·21]; pinteraction <0·0001). Interpretation Current alcohol consumption had differing associations by clinical outcome, and differing associations by income region. However, we identified sufficient commonalities to support global health strategies and national initiatives to reduce harmful alcohol use. Funding Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, GlaxoSmithKline, Novartis, King Pharma, and national or local organisations in participating countries.
subject
0Abridged Index Medicus
1Admission and discharge
2Adult
3Aged
4Alcohol Drinking - epidemiology
5Alcohol use
6Alcoholic beverages
7Alcohols
8Analysis
9Blood pressure
10Canada
11Cancer
12Cardiovascular disease
13Cardiovascular diseases
14Cardiovascular Diseases - epidemiology
15Cerebral infarction
16Cohort Studies
17Consumption
18Developed Countries
19Developing Countries
20Drinking behavior
21Drinking of alcoholic beverages
22Epidemiology
23Female
24Hazard identification
25Health aspects
26Health hazards
27Health risk assessment
28Heart attack
29Heart attacks
30Hospitalization
31Hospitalization - statistics & numerical data
32Hospitals
33Humans
34Hypertension
35Income
36India
37Injuries
38Internal Medicine
39Male
40Middle Aged
41Mortality
42Myocardial infarction
43Neoplasms - epidemiology
44Oncology, Experimental
45Pharmaceuticals
46Proportional Hazards Models
47Public health
48Risk analysis
49Risk factors
50Smoking
51Stroke
52Variables
53Womens health
54Wounds and Injuries - epidemiology
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6Leong, Darryl P, PhD
7Dagenais, Gilles, Prof
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12Oguz, Ayetkin, Prof
13Chifamba, Jephat, MPhil
14Diaz, Rafael, MD
15Lear, Scott, Prof
16Avezum, Alvaro, PhD
17Kumar, Rajesh, MD
18Mohan, Viswanathan, MD
19Szuba, Andrzej, Prof
20Wei, Li, PhD
21Yang, Wang, MD
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titleAlcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study
authorSmyth, Andrew, Dr ; Teo, Koon K, Prof ; Rangarajan, Sumathy, MSc ; O'Donnell, Martin, PhD ; Zhang, Xiaohe, MSc ; Rana, Punam, MD ; Leong, Darryl P, PhD ; Dagenais, Gilles, Prof ; Seron, Pamela, MSc ; Rosengren, Annika, Prof ; Schutte, Aletta E, Prof ; Lopez-Jaramillo, Patricio, Prof ; Oguz, Ayetkin, Prof ; Chifamba, Jephat, MPhil ; Diaz, Rafael, MD ; Lear, Scott, Prof ; Avezum, Alvaro, PhD ; Kumar, Rajesh, MD ; Mohan, Viswanathan, MD ; Szuba, Andrzej, Prof ; Wei, Li, PhD ; Yang, Wang, MD ; Jian, Bo, BSc ; McKee, Martin, Prof ; Yusuf, Salim, Prof
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0Abridged Index Medicus
1Admission and discharge
2Adult
3Aged
4Alcohol Drinking - epidemiology
5Alcohol use
6Alcoholic beverages
7Alcohols
8Analysis
9Blood pressure
10Canada
11Cancer
12Cardiovascular disease
13Cardiovascular diseases
14Cardiovascular Diseases - epidemiology
15Cerebral infarction
16Cohort Studies
17Consumption
18Developed Countries
19Developing Countries
20Drinking behavior
21Drinking of alcoholic beverages
22Epidemiology
23Female
24Hazard identification
25Health aspects
26Health hazards
27Health risk assessment
28Heart attack
29Heart attacks
30Hospitalization
31Hospitalization - statistics & numerical data
32Hospitals
33Humans
34Hypertension
35Income
36India
37Injuries
38Internal Medicine
39Male
40Middle Aged
41Mortality
42Myocardial infarction
43Neoplasms - epidemiology
44Oncology, Experimental
45Pharmaceuticals
46Proportional Hazards Models
47Public health
48Risk analysis
49Risk factors
50Smoking
51Stroke
52Variables
53Womens health
54Wounds and Injuries - epidemiology
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1Teo, Koon K, Prof
2Rangarajan, Sumathy, MSc
3O'Donnell, Martin, PhD
4Zhang, Xiaohe, MSc
5Rana, Punam, MD
6Leong, Darryl P, PhD
7Dagenais, Gilles, Prof
8Seron, Pamela, MSc
9Rosengren, Annika, Prof
10Schutte, Aletta E, Prof
11Lopez-Jaramillo, Patricio, Prof
12Oguz, Ayetkin, Prof
13Chifamba, Jephat, MPhil
14Diaz, Rafael, MD
15Lear, Scott, Prof
16Avezum, Alvaro, PhD
17Kumar, Rajesh, MD
18Mohan, Viswanathan, MD
19Szuba, Andrzej, Prof
20Wei, Li, PhD
21Yang, Wang, MD
22Jian, Bo, BSc
23McKee, Martin, Prof
24Yusuf, Salim, Prof
25PURE Investigators
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jtitleThe Lancet (British edition)
delivery
delcategoryRemote Search Resource
fulltextfulltext
addata
au
0Smyth, Andrew, Dr
1Teo, Koon K, Prof
2Rangarajan, Sumathy, MSc
3O'Donnell, Martin, PhD
4Zhang, Xiaohe, MSc
5Rana, Punam, MD
6Leong, Darryl P, PhD
7Dagenais, Gilles, Prof
8Seron, Pamela, MSc
9Rosengren, Annika, Prof
10Schutte, Aletta E, Prof
11Lopez-Jaramillo, Patricio, Prof
12Oguz, Ayetkin, Prof
13Chifamba, Jephat, MPhil
14Diaz, Rafael, MD
15Lear, Scott, Prof
16Avezum, Alvaro, PhD
17Kumar, Rajesh, MD
18Mohan, Viswanathan, MD
19Szuba, Andrzej, Prof
20Wei, Li, PhD
21Yang, Wang, MD
22Jian, Bo, BSc
23McKee, Martin, Prof
24Yusuf, Salim, Prof
aucorpPURE Investigators
formatjournal
genrearticle
ristypeJOUR
atitleAlcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study
jtitleThe Lancet (British edition)
addtitleLancet
date2015
risdate2015
volume386
issue10007
spage1945
epage1954
pages1945-1954
issn0140-6736
eissn1474-547X
codenLANCAO
abstractSummary Background Alcohol consumption is proposed to be the third most important modifiable risk factor for death and disability. However, alcohol consumption has been associated with both benefits and harms, and previous studies were mostly done in high-income countries. We investigated associations between alcohol consumption and outcomes in a prospective cohort of countries at different economic levels in five continents. Methods We included information from 12 countries participating in the Prospective Urban Rural Epidemiological (PURE) study, a prospective cohort study of individuals aged 35–70 years. We used Cox proportional hazards regression to study associations with mortality (n=2723), cardiovascular disease (n=2742), myocardial infarction (n=979), stroke (n=817), alcohol-related cancer (n=764), injury (n=824), admission to hospital (n=8786), and for a composite of these outcomes (n=11 963). Findings We included 114 970 adults, of whom 12 904 (11%) were from high-income countries (HICs), 24 408 (21%) were from upper-middle-income countries (UMICs), 48 845 (43%) were from lower-middle-income countries (LMICs), and 28 813 (25%) were from low-income countries (LICs). Median follow-up was 4·3 years (IQR 3·0–6·0). Current drinking was reported by 36 030 (31%) individuals, and was associated with reduced myocardial infarction (hazard ratio [HR] 0·76 [95% CI 0·63–0·93]), but increased alcohol-related cancers (HR 1·51 [1·22–1·89]) and injury (HR 1·29 [1·04–1·61]). High intake was associated with increased mortality (HR 1·31 [1·04–1·66]). Compared with never drinkers, we identified significantly reduced hazards for the composite outcome for current drinkers in HICs and UMICs (HR 0·84 [0·77–0·92]), but not in LMICs and LICs, for which we identified no reductions in this outcome (HR 1·07 [0·95–1·21]; pinteraction <0·0001). Interpretation Current alcohol consumption had differing associations by clinical outcome, and differing associations by income region. However, we identified sufficient commonalities to support global health strategies and national initiatives to reduce harmful alcohol use. Funding Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, GlaxoSmithKline, Novartis, King Pharma, and national or local organisations in participating countries.
copEngland
pubElsevier Ltd
pmid26386538
doi10.1016/S0140-6736(15)00235-4