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Alcohol consumption and mortality from all causes,coronary heart disease,and stroke: results from a prospective cohort study of Scottish men with 21 years of follow up
Authors:Carole L Hart  George Davey Smith  David J Hole  Victor M Hawthorne
Affiliation:aDepartment of Public Health, University of Glasgow, Glasgow G12 8RZ, bDepartment of Social Medicine, University of Bristol, Bristol BS8 2PR, cWest of Scotland Cancer Surveillance Unit, University of Glasgow, Glasgow G12 8RZ, dUniversity of Michigan, School of Public Health, Department of Epidemiology, Ann Arbor, MI 48109, USA
Abstract:ObjectivesTo relate alcohol consumption to mortality.DesignProspective cohort study.Setting27 workplaces in the west of Scotland.Participants5766 men aged 35-64 when screened in 1970-3 who answered questions on their usual weekly alcohol consumption.ResultsRisk for all cause mortality was similar for non-drinkers and men drinking up to 14 units a week. Mortality risk then showed a graded association with alcohol consumption (relative rate compared with non-drinkers 1.34 (95% confidence interval 1.14 to 1.58) for 15-21 units a week, 1.49 (1.27 to 1.75) for 22-34 units, 1.74 (1.47 to 2.06) for 35 or more units). Adjustment for risk factors attenuated the increased relative risks, but they remained significantly above 1 for men drinking 22 or more units a week. There was no strong relation between alcohol consumption and mortality from coronary heart disease after adjustment. A strong positive relation was seen between alcohol consumption and risk of mortality from stroke, with men drinking 35 or more units having double the risk of non-drinkers, even after adjustment.ConclusionsThe overall association between alcohol consumption and mortality is unfavourable for men drinking over 22 units a week, and there is no clear evidence of any protective effect for men drinking less than this.

Key messages

  • Results from a large cohort study of employed Scottish men showed different relations between alcohol consumption and mortality than previous studies
  • There was no relation between mortality from coronary heart disease and alcohol consumption once adjustments were made for potential confounding factors
  • There was a strong relation with mortality from stroke; drinkers of over 35 units a week had double the risk of mortality compared with non-drinkers
  • Some but not all of this could be accounted for by alcohol related increases in blood pressure
  • Overall, risk of all cause mortality was higher in men drinking 22 or more units a week
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