Alcohol intake in relation to non-fatal and fatal coronary heart disease and stroke : EPIC-CVD case-cohort study

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Ricci , C , Wood , A , Muller , D , Gunter , M J , Agudo , A , Boeing , H , van der Schouw , Y T , Warnakula , S , Saieva , C , Spijkerman , A , Sluijs , I , Tjonneland , A , Kyro , C , Weiderpass , E , Kuehn , T , Kaaks , R , Sanchez , M-J , Panico , S , Agnoli , C , Palli , D , Tumino , R , Engstrom , G , Melander , O , Bonnet , F , Boer , J M A , Key , T J , Travis , R C , Overvad , K , Verschuren , W M M , Quiros , J R , Trichopoulou , A , Papatesta , E-M , Peppa , E , Iribas , C M , Gavrila , D , Forslund , A-S , Jansson , J-H , Matullo , G , Arriola , L , Freisling , H , Lassale , C , Tzoulaki , I , Sharp , S J , Forouhi , N G , Langenberg , C , Saracci , R , Sweeting , M , Brennan , P , Butterworth , A S & Riboli , E 2018 , ' Alcohol intake in relation to non-fatal and fatal coronary heart disease and stroke : EPIC-CVD case-cohort study ' , BMJ : British Medical Journal , vol. 361 , 934 .

Title: Alcohol intake in relation to non-fatal and fatal coronary heart disease and stroke : EPIC-CVD case-cohort study
Author: Ricci, Cristian; Wood, Angela; Muller, David; Gunter, Marc J.; Agudo, Antonio; Boeing, Heiner; van der Schouw, Yvonne T.; Warnakula, Samantha; Saieva, Calogero; Spijkerman, Annemieke; Sluijs, Ivonne; Tjonneland, Anne; Kyro, Cecilie; Weiderpass, Elisabete; Kuehn, Tilman; Kaaks, Rudolf; Sanchez, Maria-Jose; Panico, Salvatore; Agnoli, Claudia; Palli, Domenico; Tumino, Rosario; Engstrom, Gunnar; Melander, Olle; Bonnet, Fabrice; Boer, Jolanda M. A.; Key, Timothy J.; Travis, Ruth C.; Overvad, Kim; Verschuren, W. M. Monique; Quiros, J. Ramon; Trichopoulou, Antonia; Papatesta, Eleni-Maria; Peppa, Eleni; Iribas, Conchi Moreno; Gavrila, Diana; Forslund, Ann-Sofie; Jansson, Jan-Hakan; Matullo, Giuseppe; Arriola, Larraitz; Freisling, Heinz; Lassale, Camille; Tzoulaki, Ioanna; Sharp, Stephen J.; Forouhi, Nita G.; Langenberg, Claudia; Saracci, Rodolfo; Sweeting, Michael; Brennan, Paul; Butterworth, Adam S.; Riboli, Elio
Contributor organization: University of Helsinki
Date: 2018-05-29
Language: eng
Number of pages: 9
Belongs to series: BMJ : British Medical Journal
ISSN: 1756-1833
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.
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by_nc
Usage restriction: openAccess
Self-archived version: publishedVersion

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