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Circulation, Vol 89, 651-659, Copyright © 1994 by American Heart Association
RJ Goldberg, CM Burchfiel, DM Reed, G Wergowske and D Chiu
BACKGROUND: The study objective was to determine the association between
reported alcohol consumption and total mortality, mortality from selected
causes, and incident nonfatal chronic disease events in middle-aged (51 to
64 years old) and elderly (65 to 75 years old) men during an approximate
15-year follow-up period. METHODS AND RESULTS: We conducted a prospective
epidemiological study of Japanese-American men who were participating in
the Honolulu Heart Program and were free from coronary heart disease,
cerebrovascular disease, and cancer at baseline examination and at
subsequent reexamination 6 years later. Self- reported alcohol consumption
was determined twice: at the baseline examination in 1965 through 1968 and
at reexamination approximately 6 years later (1971 through 1974). Four
primary alcohol consumption groups who reported similar alcohol intake at
the time of these two clinical examinations were considered: abstainers and
light (1 to 14 mL of alcohol per day), moderate (15 to 39 mL of alcohol per
day), and heavy (> or = 40 mL of alcohol per day) drinkers. Study end
points were also determined in very light (1 to 4.9 mL of alcohol per day)
drinkers and in men who reported a change in their alcohol intake between
examinations. Longitudinal follow-up was carried out through the end of
1988 with determination of selected fatal and nonfatal events according to
alcohol intake. After controlling for several potentially confounding
factors, total mortality exhibited a J-shaped pattern in relation to
alcohol consumption in middle-aged and elderly men. There was a trend for
lower rates of occurrence of combined fatal and nonfatal coronary heart
disease events with increasing alcohol consumption in both middle-aged and
elderly men. Increasing alcohol consumption was related to an increased
risk of fatal and nonfatal strokes in middle-aged men, whereas elderly
light and moderate drinkers were at increased risk for fatal and nonfatal
strokes. Heavy drinkers were at increased risk for fatal and nonfatal
malignant neoplasms in the two age groups examined. CONCLUSIONS: The
results of this long-term prospective study provide a balanced perspective
of the health effects of alcohol consumption in middle-aged and elderly
men. High levels of alcohol consumption were shown to be related to an
increasing risk of diseases of considerable public health importance. These
findings suggest that caution be taken in formulating population-wide
recommendations for increases in the population levels of alcohol consumed
given the associated significant social and biological problems of high
consumption levels.
ARTICLES
A prospective study of the health effects of alcohol consumption in middle-aged and elderly men. The Honolulu Heart Program
Department of Medicine, University of Massachusetts Medical School, Worcester.
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