Link between alcohol consumption and cardiovascular death depends on socioeconomics

Very frequent consumption of alcohol is associated with an increased risk of dying from cardiovascular disease, but only among people in the lowest socioeconomic position, according to a new research study published in PLOS Medicine by Eirik Degerud from the Norwegian Institute of Public Health in Oslo, and colleagues.

Individuals with low socioeconomic position are known to consume alcohol less frequently than those in higher positions, but experience a higher rate of alcohol-related hospitalizations and deaths. Degerud and colleagues analyzed socioeconomic and health survey data, as well as cause of death information, on 207,394 Norwegian adults who were born before October 15, 1960 and completed mandatory censuses in Norway between 1960 and 1990.

Moderately frequent alcohol consumers (2-3 times per week) had a lower risk of dying from cardiovascular disease than infrequent drinkers, and this association was more pronounced among people in the highest socioeconomic position. Very frequent consumption of alcohol (4-7 times per week) was associated with an increased risk of dying from cardiovascular disease among people in the lowest socioeconomic position. The authors also report that weekly binge drinkers had higher risk of dying from cardiovascular disease than those who did not binge drink in the past year, but the risk did not seem to differ by socioeconomic position.

"It is unclear if [these difference in risk] reflects differential confounding of alcohol consumption with health-protective or damaging exposures or differing effects of alcohol on health across socioeconomic groups," the authors say. "The heterogeneity between groups in the population needs to be assessed when making population recommendations regarding alcohol consumption."

In an accompanying Perspective, Jurgen Rehm and Charlotte Probst of Canada's Centre for Addiction and Mental Health write that the new findings are an important piece of the puzzle in understanding the complex interactions between socioeconomic position and mortality. An implication of the new paper, they say, is that "it is not appropriate simply to extrapolate from risks associated with alcohol use in higher-income populations to address lower-income populations where the impact of alcohol use is highest."

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Funding:

The study is part of a research project that was funded by the Research Council of Norway (grant number 2137788, https://www.forskningsradet.no). ØN received the funding and the corresponding author ED is a postdoctoral researcher on the project. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

The authors have declared that no competing interests exist.

Degerud E, Ariansen I, Ystrom E, Graff-Iversen S, Høiseth G, Mørland J, et al. (2018) Life course socioeconomic position, alcohol drinking patterns in midlife, and cardiovascular mortality: Analysis of Norwegian population-based health surveys. PLoS Med 15(1): e1002476. https://doi.org/10.1371/journal.pmed.1002476

Norwegian Institute of Public Health, Oslo, Norway
Department of Psychology, University of Oslo, Oslo, Norway
School of Pharmacy, University of Oslo, Oslo, Norway
Diakonhjemmet Hospital, Center for Psychopharmacology, Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
Institute of Health and Society, University of Oslo, Oslo, Norway

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002476

Funding:

The authors received no specific funding for this work.

The authors have declared that no competing interests exist.

Citation:

Rehm J, Probst C (2018) What about drinking is associated with shorter life in poorer people? PLoS Med 15(1): e1002477. https://doi.org/10.1371/journal.pmed.1002477

Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada
Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada
Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002477