Abstract P522: Alcohol Consumption and Cardiovascular Mortality After Myocardial Infarction

Background: Little is known about alcohol consumption in relation to long-term mortality risk after myocardial infarction (MI). We examined alcohol consumption in relation to total, coronary heart disease (CHD) and cardiovascular disease (CVD) mortality in the Alpha Omega Cohort of Dutch post-MI patients. Methods: We included 4,365 patients (60-80y, 79% male) with MI ≤10y before enrolment. Heavy alcohol users (≥6 glasses/d) were excluded from cohort participation. Dietary intake and alcohol consumption were assessed using a 203-item validated food-frequency questionnaire. Patients were classified as non-drinkers (0 g/d, n=956), very light (>0-≤2 g/d, n=385), light (M: >2-≤10, F: >2-≤5 g/d, n=1,125), moderate (M: >10-≤30, F: >5-≤15 g/d, n=1,207) or heavy drinkers (M :>30, F: >15 g/d, n=692). Hazard ratios (HRs) for total, CHD and CVD mortality were obtained, adjusting for age, sex, education, smoking, BMI, physical activity, energy intake and other dietary factors. Results: Alcohol was consumed by 83% of men and 61% of women. During 11.1y follow up, 2,035 deaths occurred of which 575 from CHD and 801 from CVD. Compared to the reference group of very light drinkers, HRs (95%CI) for total mortality were 1.01 (0.85, 1.19) in non-drinkers, and 0.88 (0.74, 1.04), 0.85 (0.72, 1.01) and 0.91 (0.76, 1.10) in light, moderate and heavy drinkers respectively. Adding non-drinkers to the reference group did not affect HRs: 0.87 (0.78, 0.98), 0.85 (0.76, 0.96) and 0.91 (0.79, 1.05) for light, moderate and heavy drinkers. Associations were slightly stronger but non-significant for CVD and CHD mortality. Findings were roughly similar after exclusion of former drinkers (n=385), diabetics (n=883) and patients with poor health (n=1,010). Conclusion: Light to moderate alcohol consumption was weakly inversely associated with total, CVD and CHD mortality risk in post-MI patients. In this observational study, potential bias and confounding cannot be ruled out and findings should be interpreted cautiously in light of the totality of evidence.

Download Full-text

Alcohol consumption and mortality in individuals with diabetes mellitus

British Journal Of Nutrition ◽

10.1017/s0007114511006532 ◽

2011 ◽

Vol 108 (7) ◽

pp. 1307-1315 ◽

Cited By ~ 4

Author(s):

Diewertje Sluik ◽

Heiner Boeing ◽

Manuela M. Bergmann ◽

Madlen Schütze ◽

Birgit Teucher ◽

...

Keyword(s):

Diabetes Mellitus ◽

Alcohol Consumption ◽

Mortality Risk ◽

Cox Regression ◽

Total Mortality ◽

Premature Mortality ◽

Men And Women ◽

Hazard Ratios ◽

History Of ◽

Current Alcohol

Studies have suggested that moderate alcohol consumption is associated with a reduced risk of CVD and premature mortality in individuals with diabetes mellitus. However, history of alcohol consumption has hardly been taken into account. We investigated the association between current alcohol consumption and mortality in men and women with diabetes mellitus accounting for past alcohol consumption. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort was defined of 4797 participants with a confirmed diagnosis of diabetes mellitus. Men and women were assigned to categories of baseline and past alcohol consumption. Hazard ratios (HR) and 95 % CI for total mortality were estimated with multivariable Cox regression models, using light alcohol consumption (>0–6 g/d) as the reference category. Compared with light alcohol consumption, no relationship was observed between consumption of 6 g/d or more and total mortality. HR for >6–12 g/d was 0·89 (95 % CI 0·61, 1·30) in men and 0·86 (95 % CI 0·46, 1·60) in women. Adjustment for past alcohol consumption did not change the estimates substantially. In individuals who at baseline reported abstaining from alcohol, mortality rates were increased relative to light consumers: HR was 1·52 (95 % CI 0·99, 2·35) in men and 1·81 (95 % CI 1·04, 3·17) in women. The present study in diabetic individuals showed no association between current alcohol consumption >6 g/d and mortality risk compared with light consumption. The increased mortality risk among non-consumers appeared to be affected by their past alcohol consumption rather than their current abstinence.

Download Full-text

Abstract P107: Differences in Cardiovascular Mortality Risk Among African Americans in the Minnesota Heart Survey, 1985-2015, versus African Americans in the Atherosclerosis Risk in Communities Study (ARIC) Cohort: 1987-2015

Circulation ◽

10.1161/circ.137.suppl_1.p107 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Kristen M George ◽

Aaron R Folsom ◽

Lyn M Steffen ◽

Lynne E Wagenknecht ◽

Thomas H Mosley

Keyword(s):

Risk Factors ◽

Risk Factor ◽

African Americans ◽

Mortality Risk ◽

Total Mortality ◽

Mortality Rates ◽

Death Rates ◽

Hazard Ratios ◽

Forsyth County ◽

Cvd Mortality

Geographic differences in CVD mortality across the U.S. are well-established, but frequently overlooked. ARIC enrolled African Americans (AA) from Jackson, MS and Forsyth County, NC, areas of the Southeast with some of the highest CVD mortality rates, especially among AAs. The Minnesota Heart Survey enrolled AAs from Minnesota where CVD rates are among the lowest. However, it is not known whether AAs in Minnesota also have low rates. Using these two cohorts, we assessed whether CVD-related mortality risk among AAs differs by region. Baseline measures of CVD risk factors for MHS were taken in 1985 from a population based sample of AAs, ages 45 to 65, living in the Minneapolis-St. Paul metropolitan area. These same measures were made at ARIC visit 1 (1987-89) in AA participants of the same age residing in Jackson, MS and Forsyth County, NC. CVD and total mortality were identified using ICD codes for underlying cause of death from State and National Death Index records in both cohorts. We compared MHS and ARIC on CVD death rates using Poisson regression, prevalence of risk factors, and risk factor hazard ratios using Cox regression. After risk factor adjustment, AA men in MHS had a rate of 5.2 (95% CI: 3.2, 7.2) CVD deaths per 1000 person-years compared to 15.1 (95% CI: 13.1, 17.1) for AA men in ARIC. For AA women, MHS had 4.1 (95% CI: 2.7, 5.5) CVD deaths per 1000 person-years versus 10.2 (95% CI: 9.0, 11.4) in ARIC. CVD mortality rates were higher in Jackson than Forsyth County within ARIC. CVD death rates paralleled risk factor prevalence at baseline. Compared to MHS, ARIC had significantly higher total cholesterol (215 vs. 202 mg/dL), albeit higher HDL cholesterol (55 vs. 53 mg/dL), as well as higher anti-hypertensive medication use (41 vs. 30%), diabetes (13 vs. 11%) and BMI (30 vs. 29 kg/m 2 ), while smoking did not differ. Despite risk factor differences, hazard ratios of CVD death associated with each risk factor did not differ between studies even after inclusion of a competing risk of non-CVD death. In conclusion, the CVD death rate was lower in AAs in MHS than in AAs residing in the Southeast in ARIC largely due to lower risk factor levels, since the hazard of CVD death for each risk factor did not differ. Study differences reflect incompletely identified geographic variation that need further exploration, especially in the context of health disparities, but support maintaining low risk as a key to CVD prevention.

Download Full-text

Effect of alcohol consumption on the risk of adverse events in atrial fibrillation: from the COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) registry

EP Europace ◽

10.1093/europace/euaa340 ◽

2020 ◽

Author(s):

Chewan Lim ◽

Tae-Hoon Kim ◽

Hee Tae Yu ◽

So-Ryoung Lee ◽

Myung-Jin Cha ◽

...

Keyword(s):

Atrial Fibrillation ◽

Alcohol Consumption ◽

Adverse Events ◽

Reference Group ◽

Symptom Control ◽

Adverse Outcomes ◽

Heavy Alcohol ◽

Hazard Ratios ◽

Increased Risk ◽

Heavy Alcohol Consumption

Abstract Aims The aim of this study is to determine the relationship between alcohol consumption and atrial fibrillation (AF)-related adverse events in the AF population. Methods and results A total of 9411 patients with nonvalvular AF in a prospective observational registry were categorized into four groups according to the amount of alcohol consumption—abstainer-rare, light (<100 g/week), moderate (100–200 g/week), and heavy (≥200 g/week). Data on adverse events (ischaemic stroke, transient ischaemic attack, systemic embolic event, or AF hospitalization including for AF rate or rhythm control and heart failure management) were collected for 17.4 ± 7.3 months. A Cox proportional hazard models was performed to calculate hazard ratios (HRs), and propensity score matching was conducted to validate the results. The heavy alcohol consumption group showed an increased risk of composite adverse outcomes [adjusted hazard ratio (aHR) 1.32, 95% confidence interval (CI) 1.06–1.66] compared with the reference group (abstainer-rare group). However, no significant increased risk for adverse outcomes was observed in the light (aHR 0.88, 95% CI 0.68–1.13) and moderate (aHR 0.91, 95% CI 0.63–1.33) groups. In subgroup analyses, adverse effect of heavy alcohol consumption was significant, especially among patients with low CHA2DS2-VASc score, without hypertension, and in whom β-blocker were not prescribed. Conclusion Our findings suggest that heavy alcohol consumption increases the risk of adverse events in patients with AF, whereas light or moderate alcohol consumption does not.

Download Full-text

Changes in waist circumference and risk of all-cause and CVD mortality: results from the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) cohort study

BMC Cardiovascular Disorders ◽

10.1186/s12872-019-1223-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 6

Author(s):

Angela A. Mulligan ◽

Marleen A. H. Lentjes ◽

Robert N. Luben ◽

Nicholas J. Wareham ◽

Kay-Tee Khaw

Keyword(s):

Weight Loss ◽

Waist Circumference ◽

Mortality Risk ◽

Total Mortality ◽

Later Life ◽

Central Adiposity ◽

Men And Women ◽

All Cause Mortality ◽

Cvd Mortality ◽

Prospective Investigation

Abstract Background Measures of abdominal adiposity are strongly associated with all-cause mortality and cardiovascular disease (CVD). However, data are limited and conflicting regarding the consequences of changes in body fat distribution. The main aims of this paper are to investigate the association between changes in waist circumference (WC) and all-cause and CVD mortality and to examine these changes in relation to concurrent changes in weight. Methods The European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) study recruited 25,639 participants between 1993 and 1997, aged 39–79, a number of whom also attended a second examination (1998–2000), and were followed up to 2016 for mortality. Participants were eligible for inclusion if they had WC, weight and height measurements at both time-points; those with a self-reported history of CVD or cancer, body mass index < 18.5 kg/m2 or missing data on covariates were excluded, leaving 12,337 participants for analyses. The median (IQR) follow-up time was 16.4 (15.7, 17.2) years. Hazard Ratios (HRs) for all-cause (2866 deaths) and CVD mortality (822 deaths), by categories of WC change, were determined using Cox proportional hazards analyses. Results After multivariable adjustment, the HRs (95% CIs) for all-cause mortality for men and women with a WC gain (WCG) > 5 cm were 1.51 (1.29–1.75) and 1.25 (1.06–1.46) respectively. For CVD mortality in men and women with a WCG > 5 cm, the HRs were 1.84 (1.39–2.43) and 1.15 (0.85–1.55) respectively. In analyses of concurrent changes in WC and weight, the greatest risk (HRs) (95% CIs) in men occurred with weight loss and WCG: 1.80 (1.13–2.86) for all-cause and 2.22 (1.03–4.82) for CVD mortality. In women, the greatest risk for both all-cause (HR 1.50 (1.16–1.95)) and CVD mortality (HR 1.81 (1.15–2.85)) was observed in those with weight loss and maintenance of WC (WCM). Conclusions Objectively measured WCG > 5 cm, was associated with subsequent higher total mortality risk and higher CVD mortality risk in men. Interventions focusing on preventing increase in central adiposity rather than lowering weight per se in later life may potentially have greater health benefits.

Download Full-text

Comprehensive unhealthy lifestyle is associated with alcohol consumption as J-shaped curve

European Journal of Public Health ◽

10.1093/eurpub/ckz187.134 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

I Shimoshikiryo ◽

R Ibusuki ◽

K Shimatani ◽

D Nishimoto ◽

T Takezaki ◽

...

Keyword(s):

Alcohol Consumption ◽

Healthy Lifestyle ◽

Total Mortality ◽

Baseline Survey ◽

Clinical Factors ◽

Unhealthy Lifestyle ◽

Related Factors ◽

Heavy Drinkers ◽

Habitual Exercise ◽

Using Data

Abstract Background Alcohol consumption is a confirmed risk factor for cancer as well as cardiovascular and other diseases. Decreased and increased risks with light and heavy consumption, respectively (J-shaped associations), were reported for total mortality. However, whether alcohol itself or its related-factors are involved in this association, is unclear. This study examined the background characteristics of comprehensive lifestyles and clinical factors according to alcohol consumption, using data from a baseline survey of large-scaled cohort study conducted among the general Japanese using Breslow’s healthy lifestyle index. Methods The study subjects were 23,885 males and 28,165 females aged 35 to 69 years, who were enrolled in the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study. To determine unhealthy lifestyle scores, smoking, exercise, sleeping duration, breakfast consumption, eating between meals, and obesity were combined. The odds ratios (ORs) of unhealthy lifestyles and clinical factors according to alcohol consumption were estimated using a logistic regression model. Results The ORs of combined unhealthy lifestyles decreased among light drinkers in males (0.73, 0.67-0.80) and females (0.88, 0.82-0.95), and increased among heavy drinkers (1.52, 1.27-1.83; 2.15, 1.44-3.20, respectively). These associations were not found for each unhealthy lifestyle and atherosclerosis-related factors, except for less breakfast intake in males and less frequent habitual exercise in females. Conclusions The present study suggests that the J-shaped association between comprehensive unhealthy lifestyle and alcohol consumption may be an important background factor of the association between alcohol consumption and risk of total mortality. Further study for total mortality with them is warranted. Key messages This study showed comprehensive unhealthy lifestyles were observed not only among heavy drinkers, but also among non-drinkers. Light drinkers have more healthy lifestyles, which contribute to their better health.

Download Full-text

Moderate alcohol consumption and total mortality risk: Do not advocate drinking for ‘health benefits’

Nutrition Metabolism and Cardiovascular Diseases ◽

10.1016/j.numecd.2019.06.007 ◽

2019 ◽

Vol 29 (10) ◽

pp. 1009-1010 ◽

Cited By ~ 3

Author(s):

Annie Britton

Keyword(s):

Alcohol Consumption ◽

Mortality Risk ◽

Health Benefits ◽

Total Mortality ◽

Moderate Alcohol Consumption

Download Full-text

Approximate Mortality Risks between Hyperuricemia and Diabetes in the United States

Journal of Clinical Medicine ◽

10.3390/jcm8122127 ◽

2019 ◽

Vol 8 (12) ◽

pp. 2127 ◽

Cited By ~ 2

Author(s):

Po-Hsun Chen ◽

Yu-Wei Chen ◽

Wei-Ju Liu ◽

Ssu-Wei Hsu ◽

Ching-Hsien Chen ◽

...

Keyword(s):

Mortality Risk ◽

Reference Group ◽

The United States ◽

Cox Proportional Hazards ◽

Hazard Ratio ◽

Low Risk ◽

Mortality Data ◽

Mortality Risks ◽

All Cause Mortality ◽

Cvd Mortality

Aim: This study aimed to compare mortality risks across uric acid (UA) levels between non-diabetes adults and participants with diabetes and to investigate the association between hyperuricemia and mortality risks in low-risk adults. Methods: We analyzed data from adults aged >18 years without coronary heart disease and chronic kidney disease (n = 29,226) from the National Health and Nutrition Examination Survey (1999–2010) and the associated mortality data (up to December 2011). We used the Cox proportional hazards models to examine the risk of all-cause and cause-specific (cardiovascular disease (CVD) and cancer) mortality at different UA levels between adults with and without diabetes. Results: Over a median follow-up of 6.6 years, 2069 participants died (495 from CVD and 520 from cancers). In non-diabetes adults at UA ≥ 5 mg/dL, all-cause and CVD mortality risks increased across higher UA levels (p-for-trend = 0.037 and 0.058, respectively). The lowest all-cause mortality risk in participants with diabetes was at the UA level of 5–7 mg/dL. We set the non-diabetes participants with UA levels of <7 mg/dL as a reference group. Without considering the effect of glycemic control, the all-cause mortality risk in non-diabetes participants with UA levels of ≥7 mg/dL was equivalent to risk among diabetes adults with UA levels of <7 mg/dL (hazard ratio = 1.44 vs. 1.57, p = 0.49). A similar result was shown in CVD mortality risk (hazard ratio = 1.80 vs. 2.06, p = 0.56). Conclusion: Hyperuricemia may be an indicator to manage multifaceted cardiovascular risk factors in low-risk adults without diabetes, but further studies and replication are warranted.

Download Full-text

Superiority of albumin–globulin ratio over albumin to predict mortality in patients undergoing peritoneal dialysis

Scientific Reports ◽

10.1038/s41598-020-73629-5 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Chun-Chieh Tsai ◽

Yao-Peng Hsieh ◽

Shr-Mei Tsai ◽

Chew-Teng Kor ◽

Ping-Fang Chiu

Keyword(s):

Peritoneal Dialysis ◽

Mortality Risk ◽

Demographic Data ◽

Characteristic Curve ◽

Group Versus ◽

Predictive Ability ◽

Cox Models ◽

Hazard Ratios ◽

Cox Analysis ◽

Cvd Mortality

AbstractThere is increasing evidence showing that albumin–globulin ratio (AGR) can predict the survival of patients in many types of malignancies. However, no study was done to explore the value of AGR in peritoneal dialysis (PD) patients. A total of 554 incident patients undergoing PD from January 2001 through July 2016 were enrolled for this retrospective observational study. The outcomes of interest were all-cause mortality and cardiovascular disease (CVD) mortality. Baseline patient’s socio-demographic data, pharmacotherapy, comorbidities, laboratory and PD-related parameters were collected and used in the multivariate Cox models. The predictive value of AGR on mortality risk was compared with other markers using area under the receiver operating characteristic curve (AUC) analysis. Among the study participants, there were 265 (47.83%) men and the mean follow-up time was 3.87 ± 3.15 years. Univariate Cox analysis showed that low AGR was significantly associated with worse outcomes in terms of all-cause and CVD mortality and it remained an independent predictor in the multivariate models. The fully adjusted hazard ratios for the low AGR group versus high AGR group were 2.12 (95% CI 1.34–3.35, p = 0.001) and 2.58 (95% CI 1.42–4.7, p = 0.002) for all-cause and CVD mortality, respectively. The predictive ability of AGR for mortality risk was superior to that of other biomarkers based on AUC calculations. In conclusion, low AGR was independently associated with higher all-cause and CVD mortality risks in patients undergoing PD.

Download Full-text

Association of Walnut Consumption with Total and Cause-Specific Mortality and Life Expectancy in U.S. Adults

Nutrients ◽

10.3390/nu13082699 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2699

Author(s):

Xiaoran Liu ◽

Marta Guasch-Ferré ◽

Deirdre K. Tobias ◽

Yanping Li

Keyword(s):

Life Expectancy ◽

Cox Regression ◽

Total Mortality ◽

Health Study ◽

Hazard Ratios ◽

Estimate Life Expectancy ◽

Specific Mortality ◽

Elder Adults ◽

Cvd Mortality

Walnut consumption is associated with health benefits. We aimed to (1) examine the association between walnut consumption and mortality and (2) estimate life expectancy in relation to walnut consumption in U.S. adults. We included 67,014 women of the Nurses’ Health Study (1998–2018) and 26,326 men of the Health Professionals Follow-up Study (1998–2018) who were free of cancer, heart disease, and stroke at baseline. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During up to 20 years of follow-up, we documented 30,263 deaths. The hazard ratios for total mortality across categories of walnut intake (servings/week), as compared to non-consumers, were 0.95 (95% confidence interval (CI), 0.91, 0.98) for <1 serving/week, 0.94 (95% CI, 0.89, 0.99) for 1 serving/week, 0.87 (95% CI, 0.82, 0.93) for 2–4 servings/week, and 0.86 (95% CI, 0.79, 0.93) for >=5 servings/week (p for trend <0.0001). A greater life expectancy at age 60 (1.30 years in women and 1.26 years in men) was observed among those who consumed walnuts more than 5 servings/week compared to non-consumers. Higher walnut consumption was associated with a lower risk of total and CVD mortality and a greater gained life expectancy among U.S. elder adults.

Download Full-text