Does Drinking Frequency - More Than Average Consumption - Influence Mortality?

Volume of alcohol consumption impacts the risk of coronary heart disease, with moderate drinkers at lower risk than abstainers or heavy drinkers. The effects of drinking frequency and quantity consumed per drinking session on the risk of all-cause mortality and CHD are less clear. To investigate the contributions of alcohol consumption patterns on all-cause mortality and CHD, researchers analyzed self-reported drinking habits and CHD events (angina or fatal/non-fatal myocardial infarction) in 10,308 London-based civil servants who were followed for a median of 11 years.

The relationship between average alcohol consumption at baseline and all-cause mortality and CHD at follow-up was U-shaped (moderate consumption was associated with lowest mortality and CHD rates). In analyses adjusting for multiple risk factors (e.g., age, smoking) and average consumption,

• abstinence was associated with all-cause mortality (for men, RR 2.2; non-significant for women) and CHD (for men, RR 1.8; for women, RR 2);
• drinking 2 or more times per day, compared to 1–2 times per week, was associated with all-cause mortality in both men and women (RR 2.4 and 7, respectively), but not associated with CHD;
• usual amount consumed per drinking session was not associated with all-cause mortality or CHD.

Comments:

Further study in similar cohorts may ultimately demonstrate drinking frequency as an independent predictor of all-cause mortality. However, this study’s findings should be taken with caution because drinking frequency may have been inadequately separated from total volume of consumption in statistical analyses, especially in the higher frequency categories.

Peter D. Friedmann, MD, MPH

Reference:

Britton A, Marmot M. Different measures of alcohol consumption and risk of coronary heart disease and all-cause mortality: 11-year follow-up of the Whitehall II Cohort Study. Addiction. 2004;99:109–116.
(view abstract)