Alcohol consumption and mortality in Serbia: Twenty-year follow-up study

Aim. To investigate the connection between alcohol consumption and general and specific mortality in the Serbian population. Methods. Total of 286 healthy middle-aged participants of both genders enrolled in a prospective follow-up study in 1974. During the following 20 years, 80 deaths occurred. The data on underlying causes of death were obtained from official death certificates. Alcohol consumption was estimated from a multiple-choice questionnaire. According to the total daily alcohol intake, subjects were classified into 3 groups: none- or rare drinkers, moderate, and heavy drinkers. The relative risks (RR) adjusted for gender, smoking, body mass index, and blood pressure were calculated using non-drinkers as a reference category. Results. Heavy drinkers exhibited significantly higher adjusted ratios for all-cause mortality (RR=1.970, 95% confidence interval [CI] = 1.062-3.651; p = 0.031) and myocardial infarction (RR = 2.463, 95% CI = 1.050-5.775; p = 0.038), and non-significantly higher risk for death from other causes. Moderate drinkers exhibited lower adjusted risk ratios for all-cause mortality, myocardial infarction and death from other causes, but this decrease did not reach the significance level. Further, overall probability of survival at every time point was the highest among moderate drinkers and lowest among heavy drinkers. Conclusion. Among Serbian middle-aged population moderate alcohol consumption reduced mortality from all causes, myocardial infarction and other causes of death, and increased the probability of survival in a twenty year follow-up period. Heavy drinking increased mortality rates from all causes and reduced the twenty year-survival probability in comparison with non-drinkers.