Περίληψη:
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.
Συγγραφείς:
Ricci, Cristian
Wood, Angela
Muller, David
Gunter, Marc J.
and Agudo, Antonio
Boeing, Heiner
van der Schouw, Yvonne T. and
Warnakula, Samantha
Saieva, Calogero
Spijkerman, Annemieke and
Sluijs, Ivonne
Tjonneland, Anne
Kyro, Cecilie
Weiderpass,
Elisabete
Kuehn, Tilman
Kaaks, Rudolf
Sanchez, Maria-Jose
and Panico, Salvatore
Agnoli, Claudia
Palli, Domenico and
Tumino, Rosario
Engstrom, Gunnar
Melander, Olle
Bonnet,
Fabrice
Boer, Jolanda M. A.
Key, Timothy J.
Travis, Ruth C.
and Overvad, Kim
Verschuren, W. M. Monique
Quiros, J. Ramon and
Trichopoulou, Antonia
Papatesta, Eleni-Maria
Peppa, Eleni and
Iribas, Conchi Moreno
Gavrila, Diana
Forslund, Ann-Sofie and
Jansson, Jan-Hakan
Matullo, Giuseppe
Arriola, Larraitz and
Freisling, Heinz
Lassale, Camille
Tzoulaki, Ioanna
Sharp,
Stephen J.
Forouhi, Nita G.
Langenberg, Claudia
Saracci,
Rodolfo
Sweeting, Michael
Brennan, Paul
Butterworth, Adam S.
and Riboli, Elio
Wareham, Nick J.
Danesh, John
Ferrari,
Pietro
