Alcohol intake in relation to non-fatal and fatal coronary heart disease and stroke: EPIC-CVD case-cohort study

被引：68

作者：

Ricci, Cristian ^{[1
,2
]}

Wood, Angela ^{[3
]}

Muller, David ^{[4
]}

Gunter, Marc J. ^{[5
]}

Agudo, Antonio ^{[6
]}

Boeing, Heiner ^{[7
]}

van der Schouw, Yvonne T. ^{[8
]}

Warnakula, Samantha ^{[3
]}

Saieva, Calogero ^{[9
]}

Spijkerman, Annemieke ^{[10
]}

Sluijs, Ivonne ^{[8
]}

Tjonneland, Anne ^{[11
]}

Kyro, Cecilie ^{[11
]}

Weiderpass, Elisabete ^{[12
,13
,14
]}

Kuehn, Tilman ^{[15
]}

Kaaks, Rudolf ^{[15
]}

Sanchez, Maria-Jose ^{[16
,17
]}

Panico, Salvatore ^{[18
]}

Agnoli, Claudia ^{[19
]}

Palli, Domenico ^{[9
]}

Tumino, Rosario ^{[20
]}

Engstrom, Gunnar ^{[21
]}

Melander, Olle ^{[21
]}

Bonnet, Fabrice ^{[22
]}

Boer, Jolanda M. A. ^{[10
]}

Key, Timothy J. ^{[23
]}

Travis, Ruth C. ^{[23
]}

Overvad, Kim ^{[24
,25
]}

Verschuren, W. M. Monique ^{[8
,10
]}

Quiros, J. Ramon ^{[26
]}

Trichopoulou, Antonia ^{[27
,28
]}

Papatesta, Eleni-Maria ^{[28
]}

Peppa, Eleni ^{[27
]}

Iribas, Conchi Moreno ^{[29
,30
]}

Gavrila, Diana ^{[17
,31
]}

Forslund, Ann-Sofie ^{[3
,32
]}

Jansson, Jan-Hakan ^{[33
]}

Matullo, Giuseppe ^{[34
]}

Arriola, Larraitz ^{[35
]}

Freisling, Heinz ^{[1
]}

Lassale, Camille ^{[4
,36
]}

Tzoulaki, Ioanna ^{[4
,37
]}

Sharp, Stephen J. ^{[38
]}

Forouhi, Nita G. ^{[38
]}

Langenberg, Claudia ^{[38
]}

Saracci, Rodolfo ^{[1
]}

Sweeting, Michael ^{[3
]}

Brennan, Paul ^{[39
]}

Butterworth, Adam S. ^{[3
]}

Riboli, Elio ^{[4
]}

机构：

[1] WHO, Int Agcy Res Canc, Nutr Methodol & Biostat Grp, 150 Cours Albert Thomas, F-69372 Lyon 08, France

[2] North West Univ, Ctr Excellence Nutr, Potchefstroom, South Africa

[3] Univ Cambridge, Dept Publ Hlth & Primary Care, Cardiovasc Epidemiol Unit, Med Res Council,British Heart Fdn, Cambridge, England

[4] Imperial Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England

[5] Int Agcy Res Canc, Nutr & Metab Sect, Nutr Epidemiol Grp, Lyon, France

[6] Catalan Inst Oncol, Canc Epidemiol Res Program, Unit Nutr Environm & Canc, Barcelona, Spain

[7] German Inst Human Nutr Potsdam Rehbrucke, Dept Epidemiol, Nuthetal, Germany

[8] Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands

[9] Canc Res & Prevent Inst, Canc Risk Factors & Lifestyle Epidemiol Unit, Florence, Italy

[10] Natl Inst Publ Hlth & Environm, Ctr Nutr Prevent & Hlth Serv, Bilthoven, Netherlands

[11] Danish Canc Soc Res Ctr, Copenhagen, Denmark

[12] Arctic Univ Norway, Univ Tromso, Fac Hlth Sci, Dept Community Med, Tromso, Norway

[13] Univ Helsinki, Folkhalsan Res Ctr, Genet Epidemiol Grp, Helsinki, Finland

[14] Univ Helsinki, Fac Med, Helsinki, Finland

[15] German Canc Res Ctr, Div Canc Epidemiol, Heidelberg, Germany

[16] Univ Granada, Andaluzian Sch Publ Hlth, Granada, Spain

[17] Biomed Res Networking Ctr Epidemiol & Publ Hlth C, Madrid, Spain

[18] Univ Naples Federico II, Dept Clin Med & Surg, Naples, Italy

[19] Fdn IRCCS Ist Nazl Tumori, Epidemiol & Prevent Unit, Milan, Italy

[20] Civ M P Arezzo Hosp, Canc Registry & Histopathol Dept, Ragusa, Italy

[21] Lund Univ, Dept Clin Sci, Malmo, Sweden

[22] Rennes Univ Hosp, Rennes, France

[23] Univ Oxford, Nuffield Dept Populat Hlth, Canc Epidemiol Unit, Oxford, England

[24] Aarhus Univ, Epidemiol Sect, Dept Publ Hlth, Aarhus, Denmark

[25] Aalborg Univ Hosp, Dept Cardiol, Aalborg, Denmark

[26] Publ Hlth Directorate Asturias, Oviedo, Spain

[27] Hellen Hlth Fdn, Athens, Greece

[28] Univ Athens, WHO Collaborating Ctr Nutr & Hlth, Unit Nutr Epidemiol & Nutr Publ Hlth, Sch Med, Athens, Greece

[29] Inst Hlth Res IdiSNA, Navarre Publ Hlth Inst, Pamplona, Spain

[30] Res Network Hlth Serv Chron Dis REDISSEC, Pamplona, Spain

[31] IMIB Arrixaca, Murcia Reg Hlth Council, Dept Epidemiol, Murcia, Spain

[32] Umea Univ, Sunderby Res Unit, Dept Publ Hlth & Clin Med, Umea, Sweden

[33] Umea Univ, Dept Med, Skelleftea Res Unit, Dept Publ Hlth & Clin Med, Umea, Sweden

[34] Univ Torino, Dept Med Sci, IIGM, HuGeF, Turin, Italy

[35] Basque Govt, Inst Biodonostia, Publ Hlth Div Gipuzkoa, Gipuzkoa, Spain

[36] UCL, Dept Epidemiol & Publ Hlth, London, England

[37] Univ Ioannina, Sch Med, Dept Hyg & Epidemiol, Ioannina, Greece

[38] Univ Cambridge, Med Res Council, Epidemiol Unit, Cambridge, England

[39] Int Agcy Res Canc, Genet Sect, Genet Epidemiol Grp, Lyon, France

来源：

BMJ-BRITISH MEDICAL JOURNAL | 2018年 / 361卷

基金：

英国医学研究理事会; 欧洲研究理事会;

关键词：

INDIVIDUAL-PARTICIPANT DATA; CARDIOVASCULAR-DISEASE; SMOKING-CESSATION; RISK-FACTORS; LIFE-STYLE; CONSUMPTION; MORTALITY; METAANALYSIS; POLYPHENOLS; CANCER;

D O I：

10.1136/bmj.k934

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVE To investigate the association between alcohol consumption (at baseline and over lifetime) and non-fatal and fatal coronary heart disease (CHD) and stroke. DESIGN Multicentre case-cohort study. SETTING A study of cardiovascular disease (CVD) determinants within the European Prospective Investigation into Cancer and nutrition cohort (EPIC-CVD) from eight European countries. PARTICIPANTS 32 549 participants without baseline CVD, comprised of incident CVD cases and a subcohort for comparison. MAIN OUTCOME MEASURES Non-fatal and fatal CHD and stroke (including ischaemic and haemorrhagic stroke). RESULTS There were 9307 non-fatal CHD events, 1699 fatal CHD, 5855 non-fatal stroke, and 733 fatal stroke. Baseline alcohol intake was inversely associated with non-fatal CHD, with a hazard ratio of 0.94 (95% confidence interval 0.92 to 0.96) per 12 g/day higher intake. There was a J shaped association between baseline alcohol intake and risk of fatal CHD. The hazard ratios were 0.83 (0.70 to 0.98), 0.65 (0.53 to 0.81), and 0.82 (0.65 to 1.03) for categories 5.0-14.9 g/day, 15.0-29.9 g/day, and 30.0-59.9 g/day of total alcohol intake, respectively, compared with 0.1-4.9 g/ day. In contrast, hazard ratios for non-fatal and fatal stroke risk were 1.04 (1.02 to 1.07), and 1.05 (0.98 to 1.13) per 12 g/day increase in baseline alcohol intake, respectively, including broadly similar findings for ischaemic and haemorrhagic stroke. Associations with cardiovascular outcomes were broadly similar with average lifetime alcohol consumption as for baseline alcohol intake, and across the eight countries studied. There was no strong evidence for interactions of alcohol consumption with smoking status on the risk of CVD events. CONCLUSIONS Alcohol intake was inversely associated with non-fatal CHD risk but positively associated with the risk of different stroke subtypes. This highlights the opposing associations of alcohol intake with different CVD types and strengthens the evidence for policies to reduce alcohol consumption.

引用

页数：9

共 34 条

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