Author + information
- Received December 17, 1998
- Revision received July 30, 1999
- Accepted October 5, 1999
- Published online January 1, 2000.
- J.Michael Gaziano, MD∗,†,§∥,* (, )
- Thomas A. Gaziano, MD∗,§,
- Robert J. Glynn, PhD∗,§,¶,
- Howard D. Sesso, MPH∗,§,#,
- Umed A. Ajani, MBBS∗,§,
- Meir J. Stampfer, MD‡,§,#∗∗,
- JoAnn E. Manson, MD∗,‡,§,# and
- Julie E. Buring, ScD∗,§,#,††
- ↵*Reprint requests and correspondence: Dr. J. Michael Gaziano, Brigham and Women’s Hospital, 900 Commonwealth Avenue East, Boston, Massachusetts 02215-1204
- Charles H. Hennekens, MD
This study examined the relationship between light-to-moderate alcohol consumption and cause-specific mortality.
Previous studies suggest a J-shaped relation between alcohol and total mortality in men. A decrease in cardiovascular disease (CVD) mortality without a significant increase in other causes of mortality may explain the overall risk reduction at light-to-moderate levels.
We conducted a prospective cohort study of 89,299 U.S. men from the Physicians’ Health Study enrollment cohort who were 40 to 84 years old in 1982 and free of known myocardial infarction, stroke, cancer or liver disease at baseline. Usual alcohol consumption was estimated by a limited food frequency questionnaire.
There were 3,216 deaths over 5.5 years of follow-up. We observed a U-shaped relationship between alcohol consumption and total mortality. Compared with rarely/never drinkers, consumers of 1, 2 to 4 and 5 to 6 drinks per week and 1 drink per day had significant reductions in risk of death (multivariate relative risks [RRs] of 0.74, 0.77, 0.78 and 0.82, respectively) with no overall benefit or harm detected at the ≥2 drinks per day level (RR = 0.95; 95% confidence interval (CI), 0.79 to 1.14). The relationship with CVD mortality was inverse or L-shaped with apparent risk reductions even in the highest category of ≥2 drinks per day (RR = 0.76; 95% CI, 0.57 to 1.01). We found no clear harm or benefit for total or common site-specific cancers. For remaining other cancers, there was a nonsignificant 28% increased risk for those consuming ≥2 drinks per day.
These data support a U-shaped relation between alcohol and total mortality among light-to-moderate drinking men. The U-shaped curve may reflect an inverse association for CVD mortality, no association for common site-specific cancers and a possible positive association for less common cancers.
☆ This study was supported by research grant HL-42441 and institutional training grant HL-07575 from the National Heart, Lung and Blood Institute, Bethesda, Maryland.
- Received December 17, 1998.
- Revision received July 30, 1999.
- Accepted October 5, 1999.
- American College of Cardiology