Modelling the impact of alcohol consumption on cardiovascular disease mortality for comparative risk assessments: an overview.
Although alcohol consumption has long been considered as a risk factor for chronic disease, the relationship to cardiovascular disease (CVD) is complex and involves at least two dimensions: average volume of alcohol consumption and patterns of drinking. The objective of this contribution was to estimate the burden of CVD mortality caused by alcohol consumption.



Risk assessment modelling with alcohol-attributable CVD mortality as primary outcome. The mortality burden of ischaemic heart disease (IHD) and ischaemic stroke (IS) attributable to alcohol consumption was estimated using attributable-fraction methodology. Relative Risk (RR) data for IHD and IS were obtained from the most comprehensive meta-analyses (except for Russia and surrounding countries where alcohol RR data were obtained from a large cohort study). Age-group specific RRs were calculated, based on large studies. Data on mortality were obtained from the World Health Organization's Global Health Estimates and alcohol consumption data were obtained from the Global Information System on Alcohol and Health. Risk of former drinkers was modelled taking into account global differences in the prevalence of sick quitters among former drinkers. Alcohol-attributable mortality estimates for all other CVD causes except IHD and IS were obtained from the 2014 Global Status Report on Alcohol and Health.



An estimated 780,381 CVD deaths (441,893 and 338,490 CVD deaths among men and women respectively) were attributable to alcohol consumption globally in 2012, accounting for 1.4 % of all deaths and 26.6 % of all alcohol-attributable deaths. This is in contrast to the previously estimated 1,128,273 CVD deaths attributable to alcohol consumption globally, and represents a decrease of 30.8 % in alcohol-attributable CVD mortality and of 10.6 % in the global burden of all alcohol-attributable deaths.



When the most comprehensive and recent systematic reviews and meta-analyses are taken as bases, the net impact of alcohol consumption on CVD is lower than previously estimated.
Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1, ON, Canada. jtrehm@gmail.com.|Addiction Policy, Dalla Lana School of Public Health, University of Toronto (UofT), 155 College Street, 6th FL, Toronto, M5T 3 M7, ON, Canada. jtrehm@gmail.com.|Department of Psychiatry, Faculty of Medicine, UofT, 250 College Street, 8th FL, Toronto, M5T 1R8, ON, Canada. jtrehm@gmail.com.|Faculty of Medicine, Institute of Medical Science, UofT, Medical Sciences Bldg, 1 King's College Circle, Room 2374, Toronto, M5S 1A8, ON, Canada. jtrehm@gmail.com.|Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, Dresden, 01187, Germany. jtrehm@gmail.com.
Jürgen
J
Rehm
Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1, ON, Canada.|Faculty of Medicine, Institute of Medical Science, UofT, Medical Sciences Bldg, 1 King's College Circle, Room 2374, Toronto, M5S 1A8, ON, Canada.
Kevin D
KD
Shield
Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1, ON, Canada.
Michael
M
Roerecke
Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1, ON, Canada.|School of Electrical Engineering and Telecommunications, The University of New South Wales, High Street, Kensington, NSW 2052, Australia.|Implant Systems Group, National Information and Communications Technology Australia, Sydney, Australia 13 Garden Street, Eveleigh, NSW 2015, Australia.
Gerrit
G
Gmel
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D055815:Young Adult
Alcohol consumption; Cardiovascular disease; Global health; Ischaemic heart disease; Ischaemic stroke; Mortality