期刊
ECLINICALMEDICINE
卷 33, 期 -, 页码 -出版社
ELSEVIER
DOI: 10.1016/j.eclinm.2020.100692
关键词
Cuba; Alcohol; Mortality; Prospective study
资金
- UK Medical Research Council (MRC)
- British Heart Foundation (BHF)
- Cancer Research UK (CRUK) in the Nuffield Department of Population Health (NDPH), University of Oxford (Oxford, UK)
- US Centers for Disease Control and Prevention (CDC) Foundation (Amgen)
- UK Biobank
- National Institute for Health Research Biomedical Research Centre (Oxford, UK)
- BHF Centre of Research Excellence (Oxford, UK)
A study in Cuba showed a continuous association between weekly alcohol consumption and premature mortality, suggesting that non-drinkers may have a higher risk of death. The findings support stricter alcohol consumption limits in Cuba compared to current recommendations.
Background: The associations of cause-specific mortality with alcohol consumption have been studied mainly in higher-income countries. We relate alcohol consumption to mortality in Cuba. Methods: In 1996-2002, 146 556 adults were recruited into a prospective study from the general population in five areas of Cuba. Participants were interviewed, measured and followed up by electronic linkage to national death registries until January 1, 2017. After excluding all with missing data or chronic disease at recruitment, Cox regression (adjusted for age, sex, province, education, and smoking) was used to relate mortality rate ratios (RRs) at ages 35-79 years to alcohol consumption. RRs were corrected for long-term variability in alcohol consumption using repeat measures among 20 593 participants resurveyed in 2006-08. Findings: After exclusions, there were 120 623 participants aged 35-79 years (mean age 52 [SD 12]; 67 694 [56%] women). At recruitment, 22 670 (43%) men and 9490 (14%) women were current alcohol drinkers, with 15 433 (29%) men and 3054 (5%) women drinking at least weekly; most alcohol consumption was from rum. All-cause mortality was positively and continuously associated with weekly alcohol consumption: each additional 35cl bottle of rum per week (110g of pure alcohol) was associated with similar to 10% higher risk of all-cause mortality (RR 1.08 [95%CI 1.05-1.11]). The major causes of excess mortality in weekly drinkers were cancer, vascular disease, and external causes. Non-drinkers had similar to 10% higher risk (RR 1.11 [1.09-1.14]) of all-cause mortality than those in the lowest category of weekly alcohol consumption (<1 bottle/week), but this association was almost completely attenuated on exclusion of early follow-up. Interpretation: In this large prospective study in Cuba, weekly alcohol consumption was continuously related to premature mortality. Reverse causality is likely to account for much of the apparent excess risk among non-drinkers. The findings support limits to alcohol consumption that are lower than present recommendations in Cuba. (C) 2021 The Authors. Published by Elsevier Ltd.
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