title: Alcohol, drinking pattern and all-cause, cardiovascular and alcohol-related mortality in Eastern Europe.
abstract: Alcohol has been implicated in the high mortality in Central and Eastern Europe but the magnitude of its effect, and whether it is due to regular high intake or episodic binge drinking remain unclear. The aim of this paper was to estimate the contribution of alcohol to mortality in four Central and Eastern European countries. We used data from the Health, Alcohol and Psychosocial factors in Eastern Europe is a prospective multi-centre cohort study in Novosibirsk (Russia), Krakow (Poland), Kaunas (Lithuania) and six Czech towns. Random population samples of 34,304 men and women aged 45-69 years in 2002-2005 were followed up for a median 7 years. Drinking volume, frequency and pattern were estimated from the graduated frequency questionnaire. Deaths were ascertained using mortality registers. In 230,246 person-years of follow-up, 2895 participants died from all causes, 1222 from cardiovascular diseases (CVD), 672 from coronary heart disease (CHD) and 489 from pre-defined alcohol-related causes (ARD). In fully-adjusted models, abstainers had 30-50% increased mortality risk compared to light-to-moderate drinkers. Adjusted hazard ratios (HR) in men drinking on average ≥60 g of ethanol/day (3% of men) were 1.23 (95% CI 0.95-1.59) for all-cause, 1.38 (0.95-2.02) for CVD, 1.64 (1.02-2.64) for CHD and 2.03 (1.28-3.23) for ARD mortality. Corresponding HRs in women drinking on average ≥20 g/day (2% of women) were 1.92 (1.25-2.93), 1.74 (0.76-3.99), 1.39 (0.34-5.76) and 3.00 (1.26-7.10). Binge drinking increased ARD mortality in men only. Mortality was associated with high average alcohol intake but not binge drinking, except for ARD in men.
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BTL, UK. m.bobak@ucl.ac.uk.
authors.forename: Martin
authors.initials: M
authors.lastname: Bobak
authors.affiliation: Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russia.|Novosibirsk State Medical University, Novosibirsk, Russia.
authors.forename: Sofia
authors.initials: S
authors.lastname: Malyutina
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BTL, UK.
authors.forename: Pia
authors.initials: P
authors.lastname: Horvat
authors.affiliation: Collegium Medicum, Jagiellonian University, Kraków, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Pajak
authors.affiliation: Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Abdonas
authors.initials: A
authors.lastname: Tamosiunas
authors.affiliation: National Institute of Public Health, Prague, Czech Republic.
authors.forename: Ruzena
authors.initials: R
authors.lastname: Kubinova
authors.affiliation: Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russia.
authors.forename: Galina
authors.initials: G
authors.lastname: Simonova
authors.affiliation: Collegium Medicum, Jagiellonian University, Kraków, Poland.
authors.forename: Roman
authors.initials: R
authors.lastname: Topor-Madry
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BTL, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Peasey
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BTL, UK.
authors.forename: Hynek
authors.initials: H
authors.lastname: Pikhart
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BTL, UK.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Marmot
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000401:mortality*; D000435:Alcoholic Intoxication / Q000150:complications / Q000401:mortality*; D000437:Alcoholism / Q000150:complications / Q000401:mortality*; D063425:Binge Drinking / Q000150:complications / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: Alcohol; Cardiovascular diseases; Eastern Europe; Mortality