Dataset Information

Alcohol consumption, hypertension, and total mortality among women.

ABSTRACT: Moderate alcohol consumption is associated with a reduced risk of total mortality among Caucasian women. Whether moderate alcohol consumption is associated with a reduced risk of total mortality among African-American or hypertensive women is unclear.We conducted a prospective study among 10,576 black and 105,610 white postmenopausal women from the Women's Health Initiative (WHI), without a history of cancer or cardiovascular disease, who completed the baseline examinations in 1994-1998.During the mean 8 years of follow-up, 5,608 women died. Moderate drinking (1 to <7 drinks/week) was associated with a lower risk of total mortality among Caucasians (hazard ratio (HR) = 0.81, 95% confidence interval (CI) = 0.72-0.91) and hypertensives (HR = 0.76, 95% CI = 0.65-0.87) as compared with lifetime abstention from alcohol. Among African-American moderate drinkers the risk of total mortality was HR = 0.94, 95% CI = 0.67-1.3. Current drinking (<1 drink/month or greater) was associated with a lower risk of mortality among Caucasians, including hypertensives and nonhypertensives, and hypertensive African Americans (HR = 0.74, 95% CI = 0.54-0.99) but not among nonhypertensive African Americans (HR = 1.31, 95% CI = 0.79-2.16). The stratified comparisons among African Americans were affected by the low prevalence of moderate drinking (14.6%) and the low mortality rate (37.5/10,000) among the nonhypertensive lifetime abstainers.Moderate drinking is associated with a lower risk of total mortality among Caucasian women. Current drinking is associated with a lower risk of total mortality among Caucasians, regardless of hypertensive status, and hypertensive but not nonhypertensive African-American women. The latter observation was affected by the low mortality rate among the African-American nonhypertensive lifetime abstainers.

SUBMITTER: Freiberg MS

PROVIDER: S-EPMC3104852 | biostudies-literature | 2009 Nov

REPOSITORIES: biostudies-literature

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Alcohol consumption, hypertension, and total mortality among women.

Freiberg Matthew S MS Chang Yue-Fang YF Kraemer Kevin L KL Robinson Jennifer G JG Adams-Campbell Lucile L LL Kuller Lewis L LL

American journal of hypertension 20090903 11

<h4>Background</h4>Moderate alcohol consumption is associated with a reduced risk of total mortality among Caucasian women. Whether moderate alcohol consumption is associated with a reduced risk of total mortality among African-American or hypertensive women is unclear.<h4>Methods</h4>We conducted a prospective study among 10,576 black and 105,610 white postmenopausal women from the Women's Health Initiative (WHI), without a history of cancer or cardiovascular disease, who completed the baseline ...[more]

PMID: 19730413

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Project description:ImportanceUnderstanding whether the population-level consumption of alcohol and tobacco is associated with cancer mortality is a crucial question for public health policy that has not been answered by previous studies.ObjectiveTo examine temporal associations of alcohol and tobacco consumption with overall cancer mortality in the Australian population, looking across different sex and age groups.Design, setting, and participantsThis population-based cohort study conducted a time series analysis (autoregressive integrated moving average models) using aggregate-level annual time series data from multiple sources. Data on alcohol consumption and tobacco consumption per capita between 1935 and 2014 among the Australian population aged 15 years and older were collected from the Australian Bureau of Statistics and Cancer Council Victoria. Analysis was conducted from June 1, 2017, to October 30, 2017.ExposuresSex- and age-specific cancer mortality rates from 1968 to 2014 were collected from the Australian Institute Health and Welfare.Main outcomes and measuresPopulation-level cancer mortality in different sex and age groups in Australia, controlling for the effects of health expenditure.ResultsAmong the Australian total population aged 15 years and older in this study, 50.5% were women. Cancer death rates per 100?000 persons increased from 199 in 1968 to 214 in 1989 and then decreased steadily to 162 in 2014. Taking into account lagged effects, 1-L decreases in alcohol consumption per capita were associated with a decline of 3.9% in overall cancer mortality over a 20-year period, and 1-kg decreases in tobacco consumption per capita were associated with a 16% reduction. Alcohol consumption per capita was significantly associated with overall cancer mortality among men aged 50 to 69 years and women aged 50 years and older. Tobacco consumption per capita was found to be significantly associated with overall cancer mortality only among men aged 50 years and older.Conclusions and relevanceIn this study, alcohol consumption per capita was positively associated with overall cancer mortality among older men and women, and tobacco consumption per capita was positively associated with overall cancer mortality among older men over a 20-year period. This study provides evidence that a decrease in population-level drinking and tobacco smoking could lead to a reduction in cancer mortality.

Project description:High average daily consumption of alcohol has been associated with elevated mortality risk, but more moderate consumption, relative to abstinence, has been associated with reduced mortality risk. However, average daily consumption can be complicated to assess, limiting its usefulness in both research and clinical practice. There are also concerns that average consumption fails to capture the risk associated with certain drinking patterns, such as heavy episodic drinking. This study assessed mortality associated with drinking pattern, operationalized as the frequency of both heavy and nonheavy drinking occasions.Data from the 1997 to 2001 administrations of the National Health Interview Survey (NHIS; n = 111,511) were paired with the current release of the NHIS Linked Mortality Files, which provided mortality follow-up data through the end of 2006. We estimated the impact of drinking pattern on all-cause mortality, operationalized as the frequency of heavy (5+ drinks) and nonheavy (<5 drinks) drinking occasions. Other covariates in the model included survey wave, sex, age, race/ethnicity, ratio of family income to poverty threshold, educational attainment, body mass index, and smoking status.Over a third of past-year drinkers reported heavy drinking. Mortality risk increased steadily as heavy drinking frequency increased; daily heavy drinkers exhibited an almost 2-fold risk of death compared with abstainers (p < 0.001). Regular nonheavy drinking was associated with decreased mortality, similar to the "J-shaped curve" highlighted in past research on alcohol mortality; this potential protective effect peaked around 2 nonheavy occasions per week.Any heavy drinking likely elevates mortality risk, and substantial health benefits could be realized by reducing heavy drinking occasions or limiting overall drinking. Heavy and nonheavy drinking frequencies are valid targets for clinical screening and could be helpful in assessing risk and promoting less harmful drinking behavior.

Dataset Information

Alcohol consumption, hypertension, and total mortality among women.

Publications

Alcohol consumption, hypertension, and total mortality among women.

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