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Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults

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...

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Autores principales: Armas Rojas, Nurys B., Lacey, Ben, Simadibrata, Daniel Martin, Ross, Stephanie, Varona-Pérez, Patricia, Burrett, Julie Ann, Calderón Martínez, Marcy, Lorenzo-Vázquez, Elba, Bess Constantén, Sonia, Thomson, Blake, Sherliker, Paul, Morales Rigau, José Manuel, Carter, Jennifer, Massa, M. Sofia, Hernández López, Osvaldo Jesús, Islam, Nazrul, Martínez Morales, Miguel Ángel, Alonso Alomá, Ismell, Achiong Estupiñan, Fernando, Díaz González, Mayda, Rosquete Muñoz, Noel, Cendra Asencio, Marelis, Emberson, Jonathan, Peto, Richard, Lewington, Sarah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980059/
https://www.ncbi.nlm.nih.gov/pubmed/33768200
http://dx.doi.org/10.1016/j.eclinm.2020.100692
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author Armas Rojas, Nurys B.
Lacey, Ben
Simadibrata, Daniel Martin
Ross, Stephanie
Varona-Pérez, Patricia
Burrett, Julie Ann
Calderón Martínez, Marcy
Lorenzo-Vázquez, Elba
Bess Constantén, Sonia
Thomson, Blake
Sherliker, Paul
Morales Rigau, José Manuel
Carter, Jennifer
Massa, M. Sofia
Hernández López, Osvaldo Jesús
Islam, Nazrul
Martínez Morales, Miguel Ángel
Alonso Alomá, Ismell
Achiong Estupiñan, Fernando
Díaz González, Mayda
Rosquete Muñoz, Noel
Cendra Asencio, Marelis
Emberson, Jonathan
Peto, Richard
Lewington, Sarah
author_facet Armas Rojas, Nurys B.
Lacey, Ben
Simadibrata, Daniel Martin
Ross, Stephanie
Varona-Pérez, Patricia
Burrett, Julie Ann
Calderón Martínez, Marcy
Lorenzo-Vázquez, Elba
Bess Constantén, Sonia
Thomson, Blake
Sherliker, Paul
Morales Rigau, José Manuel
Carter, Jennifer
Massa, M. Sofia
Hernández López, Osvaldo Jesús
Islam, Nazrul
Martínez Morales, Miguel Ángel
Alonso Alomá, Ismell
Achiong Estupiñan, Fernando
Díaz González, Mayda
Rosquete Muñoz, Noel
Cendra Asencio, Marelis
Emberson, Jonathan
Peto, Richard
Lewington, Sarah
author_sort Armas Rojas, Nurys B.
collection PubMed
description 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 ∼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 ∼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. FUNDING: Medical Research Council, British Heart Foundation, Cancer Research UK, CDC Foundation (with support from Amgen)
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spelling pubmed-79800592021-03-24 Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults Armas Rojas, Nurys B. Lacey, Ben Simadibrata, Daniel Martin Ross, Stephanie Varona-Pérez, Patricia Burrett, Julie Ann Calderón Martínez, Marcy Lorenzo-Vázquez, Elba Bess Constantén, Sonia Thomson, Blake Sherliker, Paul Morales Rigau, José Manuel Carter, Jennifer Massa, M. Sofia Hernández López, Osvaldo Jesús Islam, Nazrul Martínez Morales, Miguel Ángel Alonso Alomá, Ismell Achiong Estupiñan, Fernando Díaz González, Mayda Rosquete Muñoz, Noel Cendra Asencio, Marelis Emberson, Jonathan Peto, Richard Lewington, Sarah EClinicalMedicine Research paper 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 ∼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 ∼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. FUNDING: Medical Research Council, British Heart Foundation, Cancer Research UK, CDC Foundation (with support from Amgen) Elsevier 2021-03-17 /pmc/articles/PMC7980059/ /pubmed/33768200 http://dx.doi.org/10.1016/j.eclinm.2020.100692 Text en © 2021 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Research paper
Armas Rojas, Nurys B.
Lacey, Ben
Simadibrata, Daniel Martin
Ross, Stephanie
Varona-Pérez, Patricia
Burrett, Julie Ann
Calderón Martínez, Marcy
Lorenzo-Vázquez, Elba
Bess Constantén, Sonia
Thomson, Blake
Sherliker, Paul
Morales Rigau, José Manuel
Carter, Jennifer
Massa, M. Sofia
Hernández López, Osvaldo Jesús
Islam, Nazrul
Martínez Morales, Miguel Ángel
Alonso Alomá, Ismell
Achiong Estupiñan, Fernando
Díaz González, Mayda
Rosquete Muñoz, Noel
Cendra Asencio, Marelis
Emberson, Jonathan
Peto, Richard
Lewington, Sarah
Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults
title Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults
title_full Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults
title_fullStr Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults
title_full_unstemmed Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults
title_short Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults
title_sort alcohol consumption and cause-specific mortality in cuba: prospective study of 120 623 adults
topic Research paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980059/
https://www.ncbi.nlm.nih.gov/pubmed/33768200
http://dx.doi.org/10.1016/j.eclinm.2020.100692
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