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The Effect of Alcohol Intake on Cardiovascular Disease and Mortality Disappeared After Taking Lifetime Drinking and Covariates Into Account

Authors

  • Ingrid H.M. Friesema,

    1. From the Department of Health Care Studies (IHMF, PHHML), Division Medical Sociology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of General Practice (PJZ, JAK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Addiction Research Institute (MYV, HFLG), Erasmus University Rotterdam, Rotterdam, the Netherlands; Faculty of Social and Behavioral Sciences (HFLG), Tilburg University, Tilburg, the Netherlands; and Department of Methodology and Statistics (ADMK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
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  • Paul J. Zwietering,

    1. From the Department of Health Care Studies (IHMF, PHHML), Division Medical Sociology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of General Practice (PJZ, JAK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Addiction Research Institute (MYV, HFLG), Erasmus University Rotterdam, Rotterdam, the Netherlands; Faculty of Social and Behavioral Sciences (HFLG), Tilburg University, Tilburg, the Netherlands; and Department of Methodology and Statistics (ADMK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
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  • Marja Y. Veenstra,

    1. From the Department of Health Care Studies (IHMF, PHHML), Division Medical Sociology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of General Practice (PJZ, JAK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Addiction Research Institute (MYV, HFLG), Erasmus University Rotterdam, Rotterdam, the Netherlands; Faculty of Social and Behavioral Sciences (HFLG), Tilburg University, Tilburg, the Netherlands; and Department of Methodology and Statistics (ADMK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
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  • J. André Knottnerus,

    1. From the Department of Health Care Studies (IHMF, PHHML), Division Medical Sociology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of General Practice (PJZ, JAK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Addiction Research Institute (MYV, HFLG), Erasmus University Rotterdam, Rotterdam, the Netherlands; Faculty of Social and Behavioral Sciences (HFLG), Tilburg University, Tilburg, the Netherlands; and Department of Methodology and Statistics (ADMK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
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  • Henk F.L. Garretsen,

    1. From the Department of Health Care Studies (IHMF, PHHML), Division Medical Sociology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of General Practice (PJZ, JAK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Addiction Research Institute (MYV, HFLG), Erasmus University Rotterdam, Rotterdam, the Netherlands; Faculty of Social and Behavioral Sciences (HFLG), Tilburg University, Tilburg, the Netherlands; and Department of Methodology and Statistics (ADMK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
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  • Arnold D.M. Kester,

    1. From the Department of Health Care Studies (IHMF, PHHML), Division Medical Sociology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of General Practice (PJZ, JAK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Addiction Research Institute (MYV, HFLG), Erasmus University Rotterdam, Rotterdam, the Netherlands; Faculty of Social and Behavioral Sciences (HFLG), Tilburg University, Tilburg, the Netherlands; and Department of Methodology and Statistics (ADMK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
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  • Paul H.H.M. Lemmens

    1. From the Department of Health Care Studies (IHMF, PHHML), Division Medical Sociology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of General Practice (PJZ, JAK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Addiction Research Institute (MYV, HFLG), Erasmus University Rotterdam, Rotterdam, the Netherlands; Faculty of Social and Behavioral Sciences (HFLG), Tilburg University, Tilburg, the Netherlands; and Department of Methodology and Statistics (ADMK), Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
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Reprint requests: Ingrid H.M. Friesema, National Institute for Public Health (RIVM), Centre for Infectious Disease Control, Epidemiology and Surveillance Unit (intern pb 75), PO Box 1, 3720 BA Bilthoven, the Netherlands; Fax: 31-30-274-4409; E-mail: ingrid.friesema@rivm.nl

Abstract

Background:  Current alcohol intake has been associated with cardiovascular morbidity and mortality. The effect of past and lifetime drinking has received less attention. In the present study, the impact of current, past and lifetime drinking on cardiovascular events and all-cause mortality has been assessed. Secondly, the effect of accounting for covariates within these relationships has been studied.

Methods:  The Lifestyle and Health study is a prospective cohort study in 2 regions of the Netherlands. Men and women aged 45 to 70 years registered in 34 general practices were followed over the period July 1996 to June 2001. At baseline, an extensive questionnaire had to be filled in. It included 3 questionnaires about alcohol intake: a Weekly Recall, a Quantity-Frequency about last year, and the Lifetime Drinking History questionnaire. Health problems were registered by the general practitioners.

Results:  During follow-up, 679 men and 397 women had a cardiovascular event and 330 men and 204 women died. Current drinking was associated with lower risks of cardiovascular events (women) and all-cause mortality (men and women) compared with never drinkers. The relationships were strongest for alcohol intake measured with the Weekly Recall. Lifetime alcohol intake and alcohol intake in the distant past did not seem to be related to all-cause mortality or cardiovascular events. Adjustments for covariates weakened the relationships.

Conclusions:  Potential positive effects of drinking seem to be of a transient nature, as lifetime drinking and drinking in the past could not be related to all-cause mortality or cardiovascular events. The alleged benefits of current drinking at baseline diminished with increasing methodological quality and rigor.

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