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dc.contributor.authorO'Neill, Dara
dc.contributor.authorBritton, Annie
dc.contributor.authorHannah, Mary K
dc.contributor.authorGoldberg, Marcel
dc.contributor.authorKuh, Diana
dc.contributor.authorKhaw, Kay Tee
dc.contributor.authorBell, Steven
dc.date.accessioned2018-12-08T00:32:03Z
dc.date.available2018-12-08T00:32:03Z
dc.date.issued2018-08-22
dc.identifier.issn1741-7015
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/286570
dc.description.abstractBACKGROUND: Studies have shown that alcohol intake trajectories differ in their associations with biomarkers of cardiovascular functioning, but it remains unclear if they also differ in their relationship to actual coronary heart disease (CHD) incidence. Using multiple longitudinal cohort studies, we evaluated the association between long-term alcohol consumption trajectories and CHD. METHODS: Data were drawn from six cohorts (five British and one French). The combined analytic sample comprised 35,132 individuals (62.1% male; individual cohorts ranging from 869 to 14,247 participants) of whom 4.9% experienced an incident (fatal or non-fatal) CHD event. Alcohol intake across three assessment periods of each cohort was used to determine participants' intake trajectories over approximately 10 years. Time to onset for (i) incident CHD and (ii) fatal CHD was established using surveys and linked medical record data. A meta-analysis of individual participant data was employed to estimate the intake trajectories' association with CHD onset, adjusting for demographic and clinical characteristics. RESULTS: Compared to consistently moderate drinkers (males: 1-168 g ethanol/week; females: 1-112 g ethanol/week), inconsistently moderate drinkers had a significantly greater risk of incident CHD [hazard ratio (HR) = 1.18, 95% confidence interval (CI) = 1.02-1.37]. An elevated risk of incident CHD was also found for former drinkers (HR = 1.31, 95% CI = 1.13-1.52) and consistent non-drinkers (HR = 1.47, 95% CI = 1.21-1.78), although, after sex stratification, the latter effect was only evident for females. When examining fatal CHD outcomes alone, only former drinkers had a significantly elevated risk, though hazard ratios for consistent non-drinkers were near identical. No evidence of elevated CHD risk was found for consistently heavy drinkers, and a weak association with fatal CHD for inconsistently heavy drinkers was attenuated following adjustment for confounding factors. CONCLUSIONS: Using prospectively recorded alcohol data, this study has shown how instability in drinking behaviours over time is associated with risk of CHD. As well as individuals who abstain from drinking (long term or more recently), those who are inconsistently moderate in their alcohol intake have a higher risk of experiencing CHD. This finding suggests that policies and interventions specifically encouraging consistency in adherence to lower-risk drinking guidelines could have public health benefits in reducing the population burden of CHD. The absence of an effect amongst heavy drinkers should be interpreted with caution given the known wider health risks associated with such intake. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03133689 .
dc.format.mediumElectronic
dc.languageeng
dc.publisherSpringer Science and Business Media LLC
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectHumans
dc.subjectCoronary Disease
dc.subjectMyocardial Infarction
dc.subjectDisease Progression
dc.subjectIncidence
dc.subjectRisk Factors
dc.subjectCohort Studies
dc.subjectLongitudinal Studies
dc.subjectAlcohol Drinking
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectFrance
dc.subjectFemale
dc.subjectMale
dc.subjectUnited Kingdom
dc.titleAssociation of longitudinal alcohol consumption trajectories with coronary heart disease: a meta-analysis of six cohort studies using individual participant data.
dc.typeArticle
prism.issueIdentifier1
prism.publicationDate2018
prism.publicationNameBMC Med
prism.startingPage124
prism.volume16
dc.identifier.doi10.17863/CAM.33880
dcterms.dateAccepted2018-07-10
rioxxterms.versionofrecord10.1186/s12916-018-1123-6
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-08-22
dc.contributor.orcidO'Neill, Dara [0000-0002-8830-0264]
dc.contributor.orcidBell, Steven [0000-0001-6774-3149]
dc.identifier.eissn1741-7015
rioxxterms.typeJournal Article/Review
pubs.funder-project-idMedical Research Council (G0401527)
pubs.funder-project-idMedical Research Council (G1000143)
pubs.funder-project-idMedical Research Council (MR/L003120/1)
pubs.funder-project-idMedical Research Council (MR/N003284/1)
pubs.funder-project-idCancer Research Uk (None)
pubs.funder-project-idBritish Heart Foundation (None)
cam.issuedOnline2018-08-22


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International