How stable is the risk curve between alcohol and all-cause mortality and what factors influence the shape? A precision-weighted hierarchical meta-analysis

Abstract

There are systematic influences on the shape of the risk curve between alcohol and all-cause mortality. The overall beneficial effect of light to moderate drinking remained under all scenarios, indicating a high validity of the overall shape despite the heterogeneity between studies.

Posttraumatic stress disorder, alcohol use, and physical health concerns

“…Light and infrequent alcohol use was associated with fewer reported health concerns and the association reversed at higher and more frequent levels of drinking. Moreover, the present study provided a replication of this finding in women, a population in which the relations between drinking patterns and health outcomes has been less consistent (Corrao et al 2000;Gmel et al 2003;Rehm et al 2001). Heavy alcohol consumption has been associated with multiple health problems including coronary heart disease, injuries, various cancers, hypertension, and liver disease Rehm and Monteiro 2005;Room et al 2005;Standridge et al 2004).…”

Alcohol Use in Elective Total Hip Arthroplasty: Risk or Benefit?

“…Espehaug et al [7], in a matched case-control study with 674 revised hips as cases and 1343 hips as controls (primary), reported the alcohol intake association with revision risk to be J-shaped; the lowest risk was among moderate drinkers and the highest risk was among patients who consumed more than four units/week. Gmel et al [8] also found the curve depicting the consumption relationship with mortality was influenced by a combination of beneficial and harmful effects. Mukamal et al [13], in a study on long-term mortality among early survivors of acute myocardial infarction, found, compared with abstainers, patients who consumed fewer than one drink/day had a lower all-cause mortality rate than those who consumed one or more drinks/day.…”

“…However, the association between total mortality and alcohol intake was a J-shaped relationship because alcohol consumption, up to four drinks/day in men and two drinks/day in women, was inversely associated with total mortality. The curve that depicts the relationship between alcohol consumption and mortality is influenced by a combination of beneficial and harmful effects [8]. To determine the effects of prior alcohol consumption on longterm mortality among early survivors of acute myocardial infarction, Mukamal et al [13] performed a prospective cohort study with all-cause mortality as the main outcome measure and found, compared with abstainers, patients who consumed fewer than seven drinks/week had a lower allcause mortality rate than those who consumed seven or more drinks/week.…”

Métodos de investigación sobre daños en la población relacionados con el alcohol

“…Este proceder tiende a sobreestimar el efecto protector de los bajos niveles de consumo y a subestimar el efecto negativo de los niveles altos debido a que entre los abstemios hay antiguos bebedores que han dejado el alcohol por presentar problemas relacionados con esta sustancia. En consecuencia, tienen riesgo más alto de muerte por todas las causas y por coronariopatía y peor salud percibida que quienes han sido abstemios toda la vida o lo han sido de larga duración [4][5][6][7][8][9] .…”

“…Con los conocimientos actuales habría que excluir siempre a los antiguos bebedores excesivos cuando el grupo control son las personas abstemias. Sin embargo, puede ser conveniente incluir en el grupo control a los bebedores irregulares de pequeñas cantidades porque no hay evidencias de que estas conductas se asocien con daño sociosanitario y los abstemios absolutos de toda la vida son una minoría muy especial que puede introducir sesgos en las estimaciones [4][5][6][7][8][9] . Esto significa que cuando se estudian desenlaces crónicos han de usarse mediciones de la exposición al alcohol más completas y referidas a múlti-ples puntos del tiempo.…”