title: Alcohol and mortality.
abstract: OBJECTIVE
  To study the relation between alcohol intake and mortality in a large ambulatory population with attention to causes of death and differences related to age, sex, race, and baseline risk.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Prepaid comprehensive health care program facilities in Oakland and San Francisco, California.
  
  
  METHODS
  Adults (n = 128,934) who supplied data at health evaluations between 1978 and 1985.
  
  
  METHODS
  Demographic data and health history were supplied using questionnaires. Death was ascertained by an automated linkage system and was individually validated. Relative risk for death at various levels of drinking was calculated by Cox proportional hazards models using lifelong nondrinkers as the reference and controlling for eight covariables.
  
  
  RESULTS
  Heavier drinkers were at greater risk for death from noncardiovascular causes (relative risk at greater than or equal to 6 drinks per day compared with no alcohol = 1.6, 95% Cl, 1.3 to 2.0) especially cirrhosis, unnatural death, and tobacco-related cancers. This alcohol-associated risk was higher in women (relative risk for death from all causes at greater than or equal to 6 drinks per day = 2.2; Cl, 1.4 to 3.8) and younger persons (for persons less than 50 years of age, relative risk for death from all causes at greater than or equal to 6 drinks per day = 1.9; Cl, 1.3 to 2.9). Lighter drinkers were at lower risk for death from cardiovascular disease, especially coronary heart disease (relative risk at 1 to 2 drinks per day = 0.7; Cl, 0.6 to 0.9), independent of baseline risk, with the greatest reduction of risk in older persons. Lighter drinkers over 60 years of age also had a slightly lower risk for noncardiovascular death, but this finding was not independent of baseline coronary heart disease risk.
  
  
  CONCLUSIONS
  Women and younger persons appear more susceptible to the increased mortality risk of heavy drinking. The reduced cardiovascular risk of lighter drinkers is more pronounced in older persons. Lower coronary disease prevalence may reduce the noncardiovascular mortality risk of lighter drinkers.
authors.affiliation: Kaiser Permanente Medical Center, Department of Medicine, Oakland, CA 94611.
authors.forename: A L
authors.initials: AL
authors.lastname: Klatsky
authors.forename: M A
authors.initials: MA
authors.lastname: Armstrong
authors.forename: G D
authors.initials: GD
authors.lastname: Friedman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000208:ethnology / Q000401:mortality*; D000434:Alcoholic Beverages; D002423:Cause of Death; D003327:Coronary Disease / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000401:mortality; D011795:Surveys and Questionnaires; D013695:Temperance