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Access to alcohol and heart disease among patients in hospital: observational cohort study using differences in alcohol sales laws
Objective To investigate the relation between alcohol consumption and heart disease by using differences in county level alcohol sales laws as a natural experiment. Design Observational cohort study using differences in alcohol sales laws. Setting Hospital based healthcare encounters in Texas, USA....
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group Ltd.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4908314/ https://www.ncbi.nlm.nih.gov/pubmed/27301557 http://dx.doi.org/10.1136/bmj.i2714 |
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author | Dukes, Jonathan W Dewland, Thomas A Vittinghoff, Eric Olgin, Jeffrey E Pletcher, Mark J Hahn, Judith A Gladstone, Rachel A Marcus, Gregory M |
author_facet | Dukes, Jonathan W Dewland, Thomas A Vittinghoff, Eric Olgin, Jeffrey E Pletcher, Mark J Hahn, Judith A Gladstone, Rachel A Marcus, Gregory M |
author_sort | Dukes, Jonathan W |
collection | PubMed |
description | Objective To investigate the relation between alcohol consumption and heart disease by using differences in county level alcohol sales laws as a natural experiment. Design Observational cohort study using differences in alcohol sales laws. Setting Hospital based healthcare encounters in Texas, USA. Population 1 106 968 patients aged 21 or older who were residents of “wet” (no alcohol restrictions) and “dry” (complete prohibition of alcohol sales) counties and admitted to hospital between 2005 and 2010, identified using the Texas Inpatient Research Data File. Outcome measures Prevalent and incident alcohol misuse and alcoholic liver disease were used for validation analyses. The main cardiovascular outcomes were atrial fibrillation, acute myocardial infarction, and congestive heart failure. Results Residents of wet counties had a greater prevalence and incidence of alcohol misuse and alcoholic liver disease. After multivariable adjustment, wet county residents had a greater prevalence (odds ratio 1.05, 95% confidence interval 1.01 to 1.09; P=0.007) and incidence (hazard ratio 1.07, 1.01 to 1.13; P=0.014) of atrial fibrillation, a lower prevalence (odds ratio 0.83, 0.79 to 0.87; P<0.001) and incidence (hazard ratio 0.91, 0.87 to 0.99; P=0.019) of myocardial infarction, and a lower prevalence (odds ratio 0.87, 0.84 to 0.90; P<0.001) of congestive heart failure. Conversion of counties from dry to wet resulted in statistically significantly higher rates of alcohol misuse, alcoholic liver disease, atrial fibrillation, and congestive heart failure, with no detectable difference in myocardial infarction. Conclusions Greater access to alcohol was associated with more atrial fibrillation and less myocardial infarction and congestive heart failure, although an increased risk of congestive heart failure was seen shortly after alcohol sales were liberalized. |
format | Online Article Text |
id | pubmed-4908314 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BMJ Publishing Group Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-49083142016-06-22 Access to alcohol and heart disease among patients in hospital: observational cohort study using differences in alcohol sales laws Dukes, Jonathan W Dewland, Thomas A Vittinghoff, Eric Olgin, Jeffrey E Pletcher, Mark J Hahn, Judith A Gladstone, Rachel A Marcus, Gregory M BMJ Research Objective To investigate the relation between alcohol consumption and heart disease by using differences in county level alcohol sales laws as a natural experiment. Design Observational cohort study using differences in alcohol sales laws. Setting Hospital based healthcare encounters in Texas, USA. Population 1 106 968 patients aged 21 or older who were residents of “wet” (no alcohol restrictions) and “dry” (complete prohibition of alcohol sales) counties and admitted to hospital between 2005 and 2010, identified using the Texas Inpatient Research Data File. Outcome measures Prevalent and incident alcohol misuse and alcoholic liver disease were used for validation analyses. The main cardiovascular outcomes were atrial fibrillation, acute myocardial infarction, and congestive heart failure. Results Residents of wet counties had a greater prevalence and incidence of alcohol misuse and alcoholic liver disease. After multivariable adjustment, wet county residents had a greater prevalence (odds ratio 1.05, 95% confidence interval 1.01 to 1.09; P=0.007) and incidence (hazard ratio 1.07, 1.01 to 1.13; P=0.014) of atrial fibrillation, a lower prevalence (odds ratio 0.83, 0.79 to 0.87; P<0.001) and incidence (hazard ratio 0.91, 0.87 to 0.99; P=0.019) of myocardial infarction, and a lower prevalence (odds ratio 0.87, 0.84 to 0.90; P<0.001) of congestive heart failure. Conversion of counties from dry to wet resulted in statistically significantly higher rates of alcohol misuse, alcoholic liver disease, atrial fibrillation, and congestive heart failure, with no detectable difference in myocardial infarction. Conclusions Greater access to alcohol was associated with more atrial fibrillation and less myocardial infarction and congestive heart failure, although an increased risk of congestive heart failure was seen shortly after alcohol sales were liberalized. BMJ Publishing Group Ltd. 2016-06-14 /pmc/articles/PMC4908314/ /pubmed/27301557 http://dx.doi.org/10.1136/bmj.i2714 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/. |
spellingShingle | Research Dukes, Jonathan W Dewland, Thomas A Vittinghoff, Eric Olgin, Jeffrey E Pletcher, Mark J Hahn, Judith A Gladstone, Rachel A Marcus, Gregory M Access to alcohol and heart disease among patients in hospital: observational cohort study using differences in alcohol sales laws |
title | Access to alcohol and heart disease among patients in hospital: observational cohort study using differences in alcohol sales laws |
title_full | Access to alcohol and heart disease among patients in hospital: observational cohort study using differences in alcohol sales laws |
title_fullStr | Access to alcohol and heart disease among patients in hospital: observational cohort study using differences in alcohol sales laws |
title_full_unstemmed | Access to alcohol and heart disease among patients in hospital: observational cohort study using differences in alcohol sales laws |
title_short | Access to alcohol and heart disease among patients in hospital: observational cohort study using differences in alcohol sales laws |
title_sort | access to alcohol and heart disease among patients in hospital: observational cohort study using differences in alcohol sales laws |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4908314/ https://www.ncbi.nlm.nih.gov/pubmed/27301557 http://dx.doi.org/10.1136/bmj.i2714 |
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