Heavy and nonheavy drinking occasions, all-cause and cardiovascular mortality and hospitalizations: a follow-up study in a population with a low consumption level.
OBJECTIVE
The purpose of this study was to separate the effects of heavy and nonheavy episodic drinking on mortality and hospitalizations from ischemic heart disease (IHD) and other cardiovascular disease (OCVD) and on all-cause mortality.


METHODS
The respondents in Finnish drinking habit surveys in 1969, 1976 and 1984 (N = 6,394) were followed up for mortality and hospitalizations. There were 1,144 total deaths from all causes, 854 hospitalizations or deaths from IHD and 1,270 from OCVD. The main variables included total volume of consumption and total volume divided into volume consumed on heavy drinking occasions and nonheavy drinking occasions. Four alternative measures of heavy episodic drinking (HED) were also used.


RESULTS
Among males, the total volume of consumption showed a protective effect against IHD. A high volume consumed on light drinking occasions was associated with a decreased risk of IHD (hazard ratio [HR] = 0.56, confidence interval [CI]: 0.34-0.92) and an increased risk of OCVD (HR = 1.48, CI: 1.00-2.18). A high volume consumed on heavy drinking occasions was associated with an increased risk of all-cause mortality (HR = 1.34, CI: 1.04-1.73). Among females, a protective effect of total and non-HED volume against all-cause mortality and non-HED volume against IHD was observed.


CONCLUSIONS
The findings contribute to the cumulating evidence that drinking pattern matters. Moderate drinking is associated with a lower risk of IHD, whereas drinking in a heavy episodic manner (often referred to as "binge drinking") is not. The results underline the importance of considering, in addition to the volume of consumption, the pattern of drinking in epidemiological studies.
Makelä
Pia
P
Alcohol and Drug Research Group, STAKES, P.O. Box 220, 00531 Helsinki, Finland. pia.makela@stakes.fi
Paljärvi
Tapio
T
Poikolainen
Kari
K
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology*; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006184:Habits; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013695:Temperance