Risk thresholds for alcohol consumption combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies

doi:10.1016/S0140-6736(18)30134-X

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Fältnamn	Indikatorer	Metadata
000		09977naa a22019453a 4500
001		22696515
003		SE-LIBR
005		20180529112424.0
007		cr\|\|\|\|\|\|\|\|\|\|\|\|
008		180529s2018 sw \|\|\|\| o \|\|\|\| \|\|eng c
024	7	a http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1472952 uri
024	7	a urn:nbn:se:umu:diva-1472952 urn
024	7	a 10.1016/S0140-6736(18)30134-X2 doi
040		a S
041	0	a eng
042		9 EPLK
100	1	a Wood, Angela M.4 aut
245	1 0	a Risk thresholds for alcohol consumptionh [Elektronisk resurs]b combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies
260		b Elsevierc 2018
500		a Published
506	0	a gratis
520		a Background: Low-risk limits recommended for alcohol consumption vary substantially across different national guidelines. To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, we studied individual-participant data from 599 912 current drinkers without previous cardiovascular disease. Methods: We did a combined analysis of individual-participant data from three large-scale data sources in 19 high-income countries (the Emerging Risk Factors Collaboration, EPIC-CVD, and the UK Biobank). We characterised dose-response associations and calculated hazard ratios (HRs) per 100 g per week of alcohol (12.5 units per week) across 83 prospective studies, adjusting at least for study or centre, age, sex, smoking, and diabetes. To be eligible for the analysis, participants had to have information recorded about their alcohol consumption amount and status (ie, non-drinker vs current drinker), plus age, sex, history of diabetes and smoking status, at least 1 year of follow-up after baseline, and no baseline history of cardiovascular disease. The main analyses focused on current drinkers, whose baseline alcohol consumption was categorised into eight predefined groups according to the amount in grams consumed per week. We assessed alcohol consumption in relation to all-cause mortality, total cardiovascular disease, and several cardiovascular disease subtypes. We corrected HRs for estimated long-term variability in alcohol consumption using 152 640 serial alcohol assessments obtained some years apart (median interval 5.6 years [5th-95th percentile 1.04-13.5]) from 71 011 participants from 37 studies. Findings: In the 599 912 current drinkers included in the analysis, we recorded 40 310 deaths and 39 018 incident cardiovascular disease events during 5.4 million person-years of follow-up. For all-cause mortality, we recorded a positive and curvilinear association with the level of alcohol consumption, with the minimum mortality risk around or below 100 g per week. Alcohol consumption was roughly linearly associated with a higher risk of stroke (HR per 100 g per week higher consumption 1.14, 95% CI, 1.10-1.17), coronary disease excluding myocardial infarction (1.06, 1.00-1.11), heart failure (1.09, 1.03-1.15), fatal hypertensive disease (1.24, 1.15-1.33); and fatal aortic aneurysm (1.15, 1.03-1.28). By contrast, increased alcohol consumption was loglinearly associated with a lower risk of myocardial infarction (HR 0.94, 0.91-0.97). In comparison to those who reported drinking >0-<= 100 g per week, those who reported drinking >100-<= 200 g per week, >200-<= 350 g per week, or >350 g per week had lower life expectancy at age 40 years of approximately 6 months, 1-2 years, or 4-5 years, respectively. Interpretation: In current drinkers of alcohol in high-income countries, the threshold for lowest risk of all-cause mortality was about 100 g/week. For cardiovascular disease subtypes other than myocardial infarction, there were no clear risk thresholds below which lower alcohol consumption stopped being associated with lower disease risk. These data support limits for alcohol consumption that are lower than those recommended in most current guidelines.
650	7	a Medical and Health Sciences2 hsv
650	7	a Health Sciences2 hsv
650	7	a Public Health, Global Health, Social Medicine and Epidemiology2 hsv
650	7	a Medicin och hälsovetenskap2 hsv
650	7	a Hälsovetenskaper2 hsv
650	7	a Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi2 hsv
650	7	a Medical and Health Sciences2 hsv
650	7	a Health Sciences2 hsv
650	7	a Substance Abuse2 hsv
650	7	a Medicin och hälsovetenskap2 hsv
650	7	a Hälsovetenskaper2 hsv
650	7	a Beroendelära2 hsv
700	1	a Kaptoge, Stephen4 aut
700	1	a Butterworth, Adam S.4 aut
700	1	a Willeit, Peter4 aut
700	1	a Warnakula, Samantha4 aut
700	1	a Bolton, Thomas4 aut
700	1	a Paige, Ellie4 aut
700	1	a Paul, Dirk S.4 aut
700	1	a Sweeting, Michael4 aut
700	1	a Burgess, Stephen4 aut
700	1	a Bell, Steven4 aut
700	1	a Astle, William4 aut
700	1	a Stevens, David4 aut
700	1	a Koulman, Albert4 aut
700	1	a Selmer, Randi M.4 aut
700	1	a Verschuren, W. M. Monique4 aut
700	1	a Sato, Shinichi4 aut
700	1	a Njolstad, Inger4 aut
700	1	a Woodward, Mark4 aut
700	1	a Salomaa, Veikko4 aut
700	1	a Nordestgaard, Borge G.4 aut
700	1	a Yeap, Bu B.4 aut
700	1	a Fletcher, Astrid4 aut
700	1	a Melander, Olle4 aut
700	1	a Kuller, Lewis H.4 aut
700	1	a Balkau, Beverley4 aut
700	1	a Marmot, Michael4 aut
700	1	a Koenig, Wolfgang4 aut
700	1	a Casiglia, Edoardo4 aut
700	1	a Cooper, Cyrus4 aut
700	1	a Arndt, Volker4 aut
700	1	a Franco, Oscar H.4 aut
700	1	a Wennberg, Patrik4 aut
700	1	a Gallacher, John4 aut
700	1	a de la Camara, Agustin Gomez4 aut
700	1	a Volzke, Henry4 aut
700	1	a Dahm, Christina C.4 aut
700	1	a Dale, Caroline E.4 aut
700	1	a Bergmann, Manuela M.4 aut
700	1	a Crespo, Carlos J.4 aut
700	1	a van der Schouw, Yvonne T.4 aut
700	1	a Kaaks, Rudolf4 aut
700	1	a Simons, Leon A.4 aut
700	1	a Lagiou, Pagona4 aut
700	1	a Schoufour, Josje D.4 aut
700	1	a Boer, Jolanda M. A.4 aut
700	1	a Key, Timothy J.4 aut
700	1	a Rodriguez, Beatriz4 aut
700	1	a Moreno-Iribas, Conchi4 aut
700	1	a Davidson, Karina W.4 aut
700	1	a Taylor, James O.4 aut
700	1	a Sacerdote, Carlotta4 aut
700	1	a Wallace, Robert B.4 aut
700	1	a Quiros, J. Ramon4 aut
700	1	a Tumino, Rosario4 aut
700	1	a Blazer, Dan G., II4 aut
700	1	a Linneberg, Allan4 aut
700	1	a Daimon, Makoto4 aut
700	1	a Panico, Salvatore4 aut
700	1	a Howard, Barbara4 aut
700	1	a Skeie, Guri4 aut
700	1	a Strandberg, Timo4 aut
700	1	a Weiderpass, Elisabete4 aut
700	1	a Nietert, Paul J.4 aut
700	1	a Psaty, Bruce M.4 aut
700	1	a Kromhout, Daan4 aut
700	1	a Salamanca-Fernandez, Elena4 aut
700	1	a Kiechl, Stefan4 aut
700	1	a Krumholz, Harlan M.4 aut
700	1	a Grioni, Sara4 aut
700	1	a Palli, Domenico4 aut
700	1	a Huerta, Jose M.4 aut
700	1	a Price, Jackie4 aut
700	1	a Sundstrom, Johan4 aut
700	1	a Arriola, Larraitz4 aut
700	1	a Arima, Hisatomi4 aut
700	1	a Travis, Ruth C.4 aut
700	1	a Panagiotakos, Demosthenes B.4 aut
700	1	a Karakatsani, Anna4 aut
700	1	a Trichopoulou, Antonia4 aut
700	1	a Kuhn, Tilman4 aut
700	1	a Grobbee, Diederick E.4 aut
700	1	a Barrett-Connor, Elizabeth4 aut
700	1	a van Schoor, Natasja4 aut
700	1	a Boeing, Heiner4 aut
700	1	a Overvad, Kim4 aut
700	1	a Kauhanen, Jussi4 aut
700	1	a Wareham, Nick4 aut
700	1	a Langenberg, Claudia4 aut
700	1	a Forouhi, Nita4 aut
700	1	a Wennberg, Maria4 aut
700	1	a Despres, Jean-Pierre4 aut
700	1	a Cushman, Mary4 aut
700	1	a Cooper, Jackie A.4 aut
700	1	a Rodriguez, Carlos J.4 aut
700	1	a Sakurai, Masaru4 aut
700	1	a Shaw, Jonathan E.4 aut
700	1	a Knuiman, Matthew4 aut
700	1	a Voortman, Trudy4 aut
700	1	a Meisinger, Christa4 aut
700	1	a Tjonneland, Anne4 aut
700	1	a Brenner, Hermann4 aut
700	1	a Palmieri, Luigi4 aut
700	1	a Dallongeville, Jean4 aut
700	1	a Brunner, Eric J.4 aut
700	1	a Assmann, Gerd4 aut
700	1	a Trevisan, Maurizio4 aut
700	1	a Gillum, Richard F.4 aut
700	1	a Ford, Ian4 aut
700	1	a Sattar, Naveed4 aut
700	1	a Lazo, Mariana4 aut
700	1	a Thompson, Simon G.4 aut
700	1	a Ferrari, Pietro4 aut
700	1	a Leon, David A.4 aut
700	1	a Smith, George Davey4 aut
700	1	a Peto, Richard4 aut
700	1	a Jackson, Rod4 aut
700	1	a Banks, Emily4 aut
700	1	a Di Angelantonio, Emanuele4 aut
700	1	a Danesh, John4 aut
710	1 2	a Umeå universitetb Medicinska fakulteten4 pbl0 268483
772	1 8	i channel recordw 18813935
773	0 8	i Värdpublikationt The Lancetg 391:10129, 1513-1523x 0140-6736
856	4 0	u http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-147295
856	4 0	u http://dx.doi.org/10.1016/S0140-6736(18)30134-X
856	4 0	u http://umu.diva-portal.org/smash/get/diva2:1210398/FULLTEXT01
910	2 s	6 710a Umeå universitet.b Medicinsk-odontologiska fakultetenu Umeå universitet.b Medicinska fakulteten
910	2 s	6 710a Medicinska fakulteten vid Umeå universitetu Umeå universitet.b Medicinska fakulteten
841		5 APISa x ab 180529\|\|0000\|\|\|\|\|001\|\|\|\|\|\|000000e 1
024	7	5 APISa urn:nbn:se:umu:diva-1472952 urn
852		5 APISb APIS
856	4 0	5 APISu http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-147295

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Av författaren/redakt...: Wood, Angela M.; Kaptoge, Stephen; Butterworth, Ada ...; Willeit, Peter; Warnakula, Saman ...; Bolton, Thomas; visa fler...; Paige, Ellie; Paul, Dirk S.; Sweeting, Michae ...; Burgess, Stephen; Bell, Steven; Astle, William; Stevens, David; Koulman, Albert; Selmer, Randi M.; Verschuren, W. M ...; Sato, Shinichi; Njolstad, Inger; Woodward, Mark; Salomaa, Veikko; Nordestgaard, Bo ...; Yeap, Bu B.; Fletcher, Astrid; Melander, Olle; Kuller, Lewis H.; Balkau, Beverley; Marmot, Michael; Koenig, Wolfgang; Casiglia, Edoard ...; Cooper, Cyrus; Arndt, Volker; Franco, Oscar H.; Wennberg, Patrik; Gallacher, John; de la Camara, Ag ...; Volzke, Henry; Dahm, Christina ...; Dale, Caroline E ...; Bergmann, Manuel ...; Crespo, Carlos J ...; van der Schouw, ...; Kaaks, Rudolf; Simons, Leon A.; Lagiou, Pagona; Schoufour, Josje ...; Boer, Jolanda M. ...; Key, Timothy J.; Rodriguez, Beatr ...; Moreno-Iribas, C ...; Davidson, Karina ...; Taylor, James O.; Sacerdote, Carlo ...; Wallace, Robert ...; Quiros, J. Ramon; Tumino, Rosario; Blazer, Dan G., ...; Linneberg, Allan; Daimon, Makoto; Panico, Salvator ...; Howard, Barbara; Skeie, Guri; Strandberg, Timo; Weiderpass, Elis ...; Nietert, Paul J.; Psaty, Bruce M.; Kromhout, Daan; Salamanca-Fernan ...; Kiechl, Stefan; Krumholz, Harlan ...; Grioni, Sara; Palli, Domenico; Huerta, Jose M.; Price, Jackie; Sundstrom, Johan; Arriola, Larrait ...; Arima, Hisatomi; Travis, Ruth C.; Panagiotakos, De ...; Karakatsani, Ann ...; Trichopoulou, An ...; Kuhn, Tilman; Grobbee, Diederi ...; Barrett-Connor, ...; van Schoor, Nata ...; Boeing, Heiner; Overvad, Kim; Kauhanen, Jussi; Wareham, Nick; Langenberg, Clau ...; Forouhi, Nita; Wennberg, Maria; Despres, Jean-Pi ...; Cushman, Mary; Cooper, Jackie A ...; Rodriguez, Carlo ...; Sakurai, Masaru; Shaw, Jonathan E ...; Knuiman, Matthew; Voortman, Trudy; Meisinger, Chris ...; Tjonneland, Anne; Brenner, Hermann; Palmieri, Luigi; Dallongeville, J ...; Brunner, Eric J.; Assmann, Gerd; Trevisan, Mauriz ...; Gillum, Richard ...; Ford, Ian; Sattar, Naveed; Lazo, Mariana; Thompson, Simon ...; Ferrari, Pietro; Leon, David A.; Smith, George Da ...; Peto, Richard; Jackson, Rod; Banks, Emily; Di Angelantonio, ...; Danesh, John; visa färre...

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