Alcohol consumption and all-cause mortality: an analysis of general practice database records for patients with long-term conditions

Background Alcohol is a risk factor for ill health and reduced life expectancy, but little is known about the impact of alcohol on mortality for people with existing long-term conditions. We used primary care data from the Clinical Practice Research Datalink (CPRD) to study relationships between alcohol consumption and all-cause mortality among general practice patients with long-term conditions. Methods Data were accessed from a sample of 125 general practices from the CPRD database. Adult patients with long-term health conditions, a record of alcohol consumption in CPRD and at least 1 year of follow-up data between 2000 and 2014 (n=95 991) were matched to the Office for National Statistics (ONS) mortality register. Results In Cox proportional hazards regression models, mortality was higher for patients consuming 25-34 units of alcohol per week (HR 1.26, 95% CI 1.12 to 1.42) and 35 units or more (HR 1.71, 95% CI 1.51 to 1.94), compared with those drinking 1-7 units per week. Patterns of mortality risk were the same for men and women. Heavy drinking increased mortality risk in combination with smoking (HR 4.04, 95% CI 3.41 to 4.79) and high levels of deprivation (HR 3.01, 95% CI 2.40 to 3.79). Conclusions Heavier drinkers with long-term conditions are at significantly greater risk of death than lighter drinkers. The findings support the UK Chief Medical Officers' guidance on having similar low-risk alcohol consumption guidelines for men and women. More needs to be done to tackle alcohol consumption among patients with long-term conditions.