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Rates of Death from All Causes, All Cardiovascular Diseases, and Alcohol-Augmented Conditions from 1982 to 1991, According to Base-Line Alcohol Consumption. Alcohol-augmented conditions are cirrhosis and alcoholism, alcohol-related cancers, breast cancer in women, and injuries and other external causes. "Less than daily" alcohol consumption was defined as drinking three or more times per week but less than one drink per day. The numbers in parentheses are the standard errors of the rates of death from all causes.
Source publication
Alcohol consumption has both adverse and beneficial effects on survival. We examined the balance of these in a large prospective study of mortality among U.S. adults.
Of 490,000 men and women (mean age, 56 years; range, 30 to 104) who reported their alcohol and tobacco use in 1982, 46,000 died during nine years of follow-up. We compared cause-speci...
Contexts in source publication
Context 1
... death rates among subjects excluded from the analyses because of miss- ing data on alcohol consumption, whose mortality patterns were consistent with most but not all of them being nondrinkers, are not shown. Figure 1 illustrates how death rates from all alco- hol-augmented conditions (cirrhosis and alcohol- ism, alcohol-related cancers, breast cancer in wom- en, and external causes) compare, at various levels of drinking, with those from all cardiovascular diseases. Overall, cardiovascular causes accounted for 45 per- cent and 37 percent of all deaths among men and women, respectively, whereas the alcohol-augment- ed conditions accounted for 7 percent of all deaths among men and 15 percent among women. ...
Context 2
... rates of death from all causes were lowest among both men and women who reported one drink daily; the rates were about 20 percent below those of nondrinkers (Fig. 1). Above one drink per day, the overall death rate among drinkers increased, although the shape of the dose-response relation with alcohol consumption varied substantially in dif- ferent subgroups of the population. Table 5 illustrates how age and background risk of cardiovascular disease influence the relation be- tween drinking and ...
Context 3
... Figure 1, which includes people of all ages, with or without cardiovascular risk factors, the U-shaped relation between alcohol consumption and mortality from all causes represents the average dose-response relation in the study population. Although most of the 20 percent reduction in rates of death from all causes among daily drinkers was attributable to lower mortality from cardiovascular causes, other nonneoplastic conditions, which are classified with "other causes" of death in Tables 3 and 4, also con- tributed. ...
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... A characteristic J-curve relationship with the lowest risk among mild-to-moderate drinkers [19][20][21] or an inverse relationship [22,23] between drinking and cardiovascular outcomes has been reported in various studies, including prospective cohort studies, population-based studies, systemic reviews, and meta-analyses. A recent large-scale population-based cohort study also reported J-shaped associations for cardiovascular disease and all-cause mortality, with moderate drinkers having a lower risk than non-drinkers and heavy drinkers exceeding guidelines [24]. ...
Background/Objectives: The impact of alcohol consumption and its restriction on clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) remains elusive. We aimed to investigate the clinical outcomes in drinkers undergoing PCI. Methods: We included 77,409 patients who underwent PCI and a health check-up within one year of the PCI using a nationwide prospective database from the Korean National Health Insurance System. Primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE), a composite of all-cause mortality, myocardial infarction, coronary revascularization, and stroke. Patients were classified as non-drinkers, within-the-guideline (≤1 standard drink in women and ≤2 in men), and above-the-guideline drinkers based on drinking status at the first health check-up after PCI. Results: During a 4.0-year follow-up duration, MACCE incidence was 19.7% (n = 15,214) (4689 [6.1%] deaths, 1916 [2.5%] MI, 2033 [2.6%] strokes, and 10,086 [13.0%] revascularizations). Both within-the-guideline- (aHR [95%CI], 0.843 [0.773–0.919]) and above-the-guideline drinkers (0.829 [0.784–0.876]) had a lower MACCE risk than the non-drinkers. A characteristic J-curve relationship was observed between the frequency or body weight-adjusted alcohol consumption and MACCE risk, with the lowest risk in the once-per-week and a mild amount per body weight (≤0.33 g/kg/week) group. Drinking habits after PCI were associated with a lower risk of adverse cardiovascular outcomes; those who continued to drink before and after PCI had the lowest risk. Conclusions: Alcohol consumption was associated with a lower risk of adverse outcomes in patients undergoing PCI. Further studies with longer-term follow-up are warranted.
... 9 Additionally, the total annual attributable deaths to alcoholic cardiomyopathy in the United States was 665 with the ratio of men to women greater than 5:1. 9 A study of 490,000 patients demonstrated increased all-cause mortality in those who were heavy drinkers under the age of 60. 10 Even acute alcohol ingestion was shown to depress the preload, afterload, and systemic vascular resistance in healthy young adults. 11 Heavy alcohol consumption (greater than 80g daily) for greater than 5 years places a person at risk for developing ACM. 8 The incidence of ACM in heavy alcohol drinkers is 1-2%. ...
Alcohol is a commonly consumed and enjoyed commodity within the global population today. Despite a purported reduction in coronary artery disease with moderate alcohol use, chronic excessive alcohol consumption can lead to deleterious health effects. While mainly associated with liver disease, injury, and mental health, it can also have devastating effects on the cardiovascular system, such as heart failure, sudden cardiac death, and stroke. More than 280 million people worldwide are currently diagnosed with alcohol use disorder. Alcohol and its metabolites exert both direct and indirect toxic effects on myocardial tissues and can lead to myocardial cell damage, apoptosis, fibrosis, and progressive myocardial dysfunction, specifically dilated cardiomyopathy. We present the current epidemiology and incidence, outline the major toxic effects of alcohol and why they occur, discuss the current guideline-directed treatment strategies, and propose targets for possible therapies in the future based on pathophysiology.
... Epidemiological findings consistently suggest a J-shaped relationship between alcohol consumption and cardiovascular disease (CVD) and all-cause mortality, highlighting beneficial effects among moderate drinkers compared to abstainers and heavy drinkers. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Recent contributions have specifically focused on wine rather than overall alcohol intake. [18][19][20][21][22][23][24][25] Therefore, an in-depth discussion comparing these findings to our own investigation is warranted. ...
Research into the relationship between alcohol consumption and health has a long-standing history. Previous studies have revealed the beneficial effects of moderate alcohol consumption on cardiovascular disease (CVD) and all-cause mortality compared to abstainers and heavy drinkers. To study the long-term impact of wine intake on mortality, we conducted a study involving 1284 men aged 45 – 64 years in 1965, followed over a period of 45 years. We analyzed their wine-drinking habits in relation to all-cause mortality and specific causes using the Cox model. In addition, we utilized a multiple regression model with age at death as the dependent variable adjusted for age, smoking habits, body mass index, physical activity, dietary score, and comorbidity index. At baseline, 97.7% of participants were drinkers, consuming alcohol at an average of 77.4 g/day (mostly from wine). After 45 years, 98.4% of men had passed away. Our findings revealed a J-shaped relationship between alcohol intake and mortality from major CVD and all causes, while the relationship was roughly linear for cancer and liver cirrhosis. The relationship with CVD and all-cause mortality remained J-shaped, even when abstainers were excluded from the analysis, indicating potential health benefits for those consuming an average of 52 g/day (range: 47 – 70 g) and a 34% excess in mortality for those consuming an average of 176 g/day (range: 142 – 570 g). The average age at death for the reference class was 3.5 years higher compared to abstainers and 3.8 years higher compared to the upper class (average: 176 g/day). Reducing alcohol intake during the first 20 years of follow-up was beneficial in terms of life expectancy. In a lifetime follow-up, the relationship between alcohol consumption and mortality formed a J-shaped curve for CVD and all-cause mortality, even when excluding abstainers. Thus, relatively high wine consumption is more beneficial than lower intakes, especially when associated with vigorous physical activity at work – a common practice among rural men in the 1960s.
... In older populations facing a high burden of cardiovascular disease, 78 small amounts of alcohol consumption are associated with improved health outcomes. 78,79 Even if the validity of the J-shaped relative risk curve has been debated, 80,81 these findings suggest that the population-average risk is a synthesis of risks for diverse health outcomes (e.g. heart disease, cancer, injuries), which have differently shaped risk relationships with alcohol consumption, and are more or less relevant to different sociodemographic groups. ...
... Hazardous alcohol use increases the risk of ischaemic heart disease, arrhythmia, heart failure and stroke [1,2], and is a leading risk factor for disability and death [1]. However, observational studies have also reported reduced cardiovascular disease mortality among regular, low-level drinkers [3,4]. These findings are controversial, and remain an active area of debate [5], being refuted by more recent research that utilize genetic predisposition for alcohol use rather than self-report, so called Mendelian randomization studies [6]. ...
Background
Hazardous alcohol use is a leading risk factor for disability and death, yet observational studies have also reported reduced cardiovascular disease mortality among regular, low-level drinkers. Such findings are refuted by more recent research, yet have received significant media coverage. We aimed to explore: (1) how patients with cardiovascular diseases access health information about moderate drinking and cardiovascular health; (2) the perceived messages these sources convey, and (3) associations with own level of alcohol use.
Methods
We conducted a cross-sectional survey of patients in cardiology services at three hospitals in Sweden. The study outcome was hazardous alcohol use, assessed using the AUDIT-C questionnaire and defined as ≥ 3 in women and ≥ 4 in men. The exposure was accessing information sources suggesting that moderate alcohol consumption can be good for the heart, as opposed to accessing information that alcohol is bad for the heart. Health information sources were described using descriptive statistics. Gender, age and education were adjusted for in multiple logistic regression analyses.
Results
A total of 330 (66.3%) of 498 patients (mean age 70.5 years, 65% males) who had heard that drinking moderately can affect the heart described being exposed to reports that moderate alcohol use can be good for the heart, and 108 (21.7%) met criteria for hazardous alcohol use. Health information sources included newspapers (32.9%), television (29.2%), healthcare staff (13.4%), friends/family (11.8%), social media (8.9%) and websites (3.7%). Participants indicated that most reports (77.9%) conveyed mixed messages about the cardiovascular effects of moderate drinking. Exposure to reports of healthy heart effects, or mixed messages about the cardiovascular effects of alcohol, was associated with increased odds of hazardous alcohol use (OR = 1.67, 95%CI = 1.02–2.74).
Conclusions
This study suggests that many patients in cardiology care access health information about alcohol from media sources, which convey mixed messages about the cardiovascular effects of alcohol. Exposure to reports that moderate drinking has protective cardiovascular effects, or mixed messages about the cardiovascular effects of alcohol, was associated with increased odds of hazardous alcohol use. Findings highlight a need for clear and consistent messages about the health effects of alcohol.
... However, several clinical studies have proven that persistent alcohol consumption is an independent predictor of mortality. [46][47][48] Indeed, patients who abstained from alcohol after the initial diagnosis of ALD have markedly improved survival compared with patients who continued to drink. Furthermore, prolonged alcohol abstinence in patients with HCC is also associated with a better overall prognosis than continued drinking. ...
Excessive alcohol consumption represents an important burden for health systems worldwide and is a major cause of liver- and cancer-related deaths. Alcohol consumption is mostly assessed by self-report that often underestimates the amount of drinking. While alcohol use disorders identification test - version C is the most widely used test for alcohol use screening, in patients with liver disease the use of alcohol biomarker could help an objective assessment. The amount of alcohol that leads to significant liver disease depends on gender, genetic background, and coexistence of comorbidities (i.e., metabolic syndrome factors). All patients with alcohol-associated liver disease are recommended to follow complete abstinence and they should be treated within multidisciplinary teams. Abstinence slows down and even reverses the progression of liver fibrosis and can help recompensate patients with complicated cirrhosis. Whether there is a safe amount of alcohol in the general population is a matter of intense debate. Large epidemiological studies showed that the safe amount of alcohol to avoid overall health-related risks is lower than expected even in the general population. Even one drink per day can increase cancer-related death. In patients with any kind of chronic liver disease, especially in those with metabolic-associated steatotic liver disease, no alcohol intake is recommended. This review article discusses the current evidence supporting the deleterious effects of small-to-moderate amounts of alcohol in the general population and in patients with underlying chronic liver disease.
... Hazardous alcohol use increases the risk of ischaemic heart disease, arrhythmia, heart failure and stroke (1,2), and is a leading risk factor for disability and death (1). However, observational studies have also reported reduced cardiovascular disease mortality among regular, low-level drinkers (3,4). These ndings are refuted by more recent research that utilize genetic predisposition for alcohol use rather than self-report, so called Mendelian randomization studies (5). ...
Background
Hazardous alcohol use is a leading risk factor for disability and death, yet observational studies have also reported reduced cardiovascular disease mortality among regular, low-level drinkers. Such findings are refuted by more recent research, yet have received significant media coverage. We aimed to explore: 1) how patients with cardiovascular diseases access health information about moderate drinking and cardiovascular health; 2) the perceived messages these sources convey, and 3) associations with own level of alcohol use.
Methods
We conducted a cross-sectional survey of patients in cardiology services at three hospitals in Sweden. The study outcome was hazardous alcohol use, assessed using the AUDIT-C questionnaire and defined as ≥ 3 in women and ≥ 4 in men. The exposure was accessing information sources suggesting that moderate alcohol consumption can be good for the heart, as opposed to accessing information that alcohol is bad for the heart. Health information sources were described using descriptive statistics. Gender, age and education were adjusted for in multiple logistic regression analyses.
Results
From 1230 eligible patients, 83% responded to relevant survey questions. Of these, 48.6% had heard that drinking moderately can affect the heart (mean age 70.5 years, 65% males). A total of 330 (62.3%) patients who had heard that drinking moderately can affect the heart described being exposed to reports that moderate alcohol use can be good for the heart, and 108 (21.7%) met criteria for hazardous alcohol use. Health information sources included newspapers (32.9%), television (29.2%), healthcare staff (13.4%), friends/family (11.8%), social media (8.9%) and websites (3.7%). Participants indicated that most reports (77.9%) conveyed mixed messages about the cardiovascular effects of moderate drinking. Exposure to reports of healthy heart effects was associated with increased odds of hazardous alcohol use (OR = 1.67, 95%CI = 1.02–2.74).
Conclusions
This study suggests that many patients in cardiology care access health information about alcohol from media sources, which convey mixed messages about the cardiovascular effects of alcohol. Exposure to reports suggesting that moderate drinking has protective cardiovascular effects was associated with increased odds of hazardous alcohol use. Findings highlight a need for clear and consistent messages about the health effects of alcohol.
... Many risk factors can increase the risk of developing cancer in anyone. Certain modifiable factors, including obesity [27], physical inactivity [28], alcohol consumption [29,30], an unhealthy lifestyle and diet [31], and tobacco consumption [28], are associated with an increased risk of cancer. Further, specific chemical and radiation exposure and nonmodifiable factors, such as a family history of cancer and older age, are also linked to cancer. ...
Cancer is a public health concern and causes more than 8 million deaths annually. Cancer triggers include population growth, aging, and variations in the prevalence and distribution of the critical risk factors for cancer. Multiple hallmarks are involved in cancer, including cell proliferation, evading growth suppressors, activating invasion and metastasis, resisting cell death, enabling replicative immortality, reprogramming energy metabolism, and evading immune destruction. Both cancer and dementia are age-related and potentially lethal, impacting survival. With increasing aging populations, cancer and dementia cause a burden on patients, family members, the health care system, and informal/formal caregivers. In the current article, we highlight cancer prevalence with a focus on different ethnic groups, ages, and genders. Our article covers risk factors and genetic causes associated with cancer and types of cancers and comorbidities. We extensively cover the impact of cancer in Hispanics in comparison to that in other ethnic groups. We also discuss the status of caregivers with cancer patients and urgent needs from the state and federal support for caregivers.
... Despite its popularity, alcohol consumption ranks as the third most important preventable cause of the disease (3), the fifth-leading risk factor for premature death and disability globally (4), and accounted for 5.1% of the global burden of disease expressed in DALYs (disability-adjusted life years) (1). Excessive alcohol consumption, referring to daily consumption of greater than three drinks (one drink is equivalent to 14 g of pure ethanol), is associated with increased risk of various diseases (5)(6)(7)(8)(9), cancers (10)(11)(12), and all-cause mortality (13). ...
... Moreover, some studies from recent years have indicated that low to moderate alcohol consumption, typically 2-3 drinks (approximately 28-42 g of ethanol) per day for men and 1-2 drinks (approximately 14-28 g of ethanol) per day for women, is associated with some beneficial health effects, such as lower risks for cardiovascular disease, dementia, and insulin resistance (18)(19)(20)(21). Moderate alcohol consumption is also associated with reduced all-cause mortality (6,10,13), and the association is often formed a J-shape relationship (10,13). Furthermore, some flavor compounds in alcoholic beverages, such as phenolic acids (in beers and wines), organic acids, esters, and terpenoids (22) (in baijiu), may also have additional impacts on health. ...
... Moreover, some studies from recent years have indicated that low to moderate alcohol consumption, typically 2-3 drinks (approximately 28-42 g of ethanol) per day for men and 1-2 drinks (approximately 14-28 g of ethanol) per day for women, is associated with some beneficial health effects, such as lower risks for cardiovascular disease, dementia, and insulin resistance (18)(19)(20)(21). Moderate alcohol consumption is also associated with reduced all-cause mortality (6,10,13), and the association is often formed a J-shape relationship (10,13). Furthermore, some flavor compounds in alcoholic beverages, such as phenolic acids (in beers and wines), organic acids, esters, and terpenoids (22) (in baijiu), may also have additional impacts on health. ...
Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease and its global incidence is estimated to be 24%. Beer, wine, and Chinese baijiu have been consumed worldwide including by the NAFLD population. A better understanding of the effects of these alcoholic beverages on NAFLD would potentially improve management of patients with NAFLD and reduce the risks for progression to fibrosis, cirrhosis, and hepatocellular carcinoma. There is evidence suggesting some positive effects, such as the antioxidative effects of bioactive flavor compounds in beer, wine, and baijiu. These effects could potentially counteract the oxidative stress caused by the metabolism of ethanol contained in the beverages. In the current review, the aim is to evaluate and discuss the current human-based and laboratory-based study evidence of effects on hepatic lipid metabolism and NAFLD from ingested ethanol, the polyphenols in beer and wine, and the bioactive flavor compounds in baijiu, and their potential mechanism. It is concluded that for the potential beneficial effects of wine and beer on NAFLD, inconsistence and contrasting data exist suggesting the need for further studies. There is insufficient baijiu specific human-based study for the effects on NAFLD. Although laboratory-based studies on baijiu showed the antioxidative effects of the bioactive flavor compounds on the liver, it remains elusive whether the antioxidative effect from the relatively low abundance of the bioactivate compounds could outweigh the oxidative stress and toxic effects from the ethanol component of the beverages.
... Many studies claim that dosage is a determinant factor in the possible nutritional and medicinal advantages of alcoholic beverage intakes. The dietary supply of several B vitamins, and minerals, such as selenium, carbohydrates and proteins, as well as polyphenols and yeast products, may promote cardioprotective effects [61][62][63], and reduce the risks of dementia [64,65] and other neurodegenerative diseases such as Alzheimer's disease [66][67][68]. On the other hand, potential beneficial effects should be addressed with caution, considering that beer ingestion, especially when aged, is a potential dietary source of aldehydes, including acetaldehyde, which is potentially harmful to human health, as it is classified as carcinogenic group 1 compound by the International Agency for Research on Cancer [12,69]. ...
Aldehydes, particularly acetaldehyde, are carcinogenic molecules and their concentrations in foodstuffs should be controlled to avoid upper aerodigestive tract (UADT) and liver cancers. Highly reactive, acetaldehyde forms DNA and protein adducts, impairing physiological functions and leading to the development of pathological conditions. The consumption of aged beer, outside of the ethanol metabolism, exposes habitual drinkers to this carcinogen, whose concentrations can be over-increased due to post-brewing chemical and biochemical reactions. Storage-related changes are a challenge faced by the brewing industry, impacting volatile compound formation and triggering flavor instability. Aldehydes are among the volatile compounds formed during beer aging, recognized as off-flavor compounds. To track and understand aldehyde formation through multiple pathways during beer storage, consequent changes in flavor but particularly quality losses and harmful compound formation, this systematic review reunited data on volatile compound profiles through gas chromatography analyses from 2011 to 2021. Conditions to avoid flavor instability and successful methods for reducing beer staling, and consequent acetaldehyde accumulation, were raised by exploring the dynamic conversion between free and bound-state aldehydes. Future research should focus on implementing sensory analyses to investigate whether adding aldehyde-binding agents, e.g., cysteine and bisulfite, would contribute to consumer acceptance, restore beer flavor, and minimize acetaldehyde-related health damage.
