Abstract
AimsTo investigate associations of life‐time hazardous and binge drinking with biomarkers of cardiometabolic health, liver function, cardiovascular disease (CVD) and mortality.DesignProspective cohort study with median follow‐up time to CVD incidence of 4.5 years.SettingLondon, UK: civil servants within the Whitehall II Study.ParticipantsA total of 4820 drinkers aged 59–83 years with biological measurements during the 2011–12 survey.MeasurementsHazardous drinking was defined as having an AUDIT‐C score ≥ 5 calculated at each decade of life, forming the following groups: never hazardous drinker, former early (stopping before age 50), former later (stopping after age 50), current hazardous drinker and consistent hazardous drinker (hazardous drinker at each decade of life).FindingsMore than half the sample had been hazardous drinkers at some point during their life‐time, comprising former early (< age 50) (19%), former later (≥ age 50) (11%), current (21%) and consistent hazardous drinker (AUDIT‐C ≥ 5 across life (5%). After adjusting for covariates, waist circumference was larger with more persistent hazardous drinking (e.g. compared with never hazardous drinkers, former early had increased waist circumference by 1.17 cm [95% confidence interval (CI) = 0.25‐2.08]; former later by 1.88 cm (CI = 0.77–2.98); current by 2.44 cm (CI = 1.50–3.34) and consistent hazardous drinker by 3.85 cm (CI = 2.23–5.47). Current hazardous drinkers had higher systolic blood pressure (2.44 mmHg, CI = 1.19–3.68) and fatty liver index scores (4.05 mmHg, CI = 2.92–5.18) than never hazardous drinkers. Current hazardous drinkers [hazard ratio (HR) = 2.75, CI = 1.44–5.22) had an elevated risk of stroke, and former later hazardous drinkers had an elevated risk of non‐CVD mortality (HR = 1.93, CI = 1.19–3.14) than never hazardous drinkers. Life‐time binge drinking was associated with larger waist circumferences and poorer liver function compared with never binge drinkers.ConclusionHazardous drinking may increase cardiometabolic risk factors; this is made worse by persistent hazardous drinking throughout life, particularly in relation to weight gain, suggesting benefits of early intervention.
Highlights
Alcohol use disorders, despite common perception, are common among an older population [1], with the number of alcohol-related admissions which list either the primary or secondary diagnoses as linked to alcohol being highest among 55–74-year-olds in the English population [2]
While there have been several large-scale observational studies of the association between alcohol consumption and cardiovascular disease (CVD) [6,7,8,9,10], relatively little is known about how hazardous drinking as defined by the Alcohol Use Disorders Identification Test (AUDIT)-C is associated with CVD or various biological markers of cardiovascular health
We examined the effect of life-time hazardous drinking on objective health, utilizing the clinical measurements taken during the medical examination in Phase 11
Summary
Despite common perception, are common among an older population [1], with the number of alcohol-related admissions which list either the primary or secondary diagnoses as linked to alcohol being highest among 55–74-year-olds in the English population [2]. Establishing the level of hazardous drinking among older adults and its consequences may enable effective public health interventions to be generated to raise awareness of the effects of alcohol among older adults and Addiction. Screening tools such as the Alcohol Use Disorders Identification Test (AUDIT), developed by the World Health Organization (WHO), provide a simple method to identify risky drinking providing a ‘framework for intervention to help hazardous and harmful drinkers reduce or cease alcohol consumption’ [4], and are commonly used in primary care settings. Capturing the effects of hazardous drinking throughout life may enhance the usefulness of the screening tool, providing further support for reduction at different stages of life
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