TY  - JOUR
PY  - 2021//
TI  - Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults
JO  - EClinicalMedicine
A1  - Armas Rojas, Nurys B.
A1  - Lacey, Ben
A1  - Simadibrata, Daniel Martin
A1  - Ross, Stephanie
A1  - Varona-Pérez, Patricia
A1  - Burrett, Julie Ann
A1  - Calderón Martínez, Marcy
A1  - Lorenzo-Vázquez, Elba
A1  - Bess Constantén, Sonia
A1  - Thomson, Blake
A1  - Sherliker, Paul
A1  - Morales Rigau, José Manuel
A1  - Carter, Jennifer
A1  - Massa, M. Sofia
A1  - Hernández López, Osvaldo Jesús
A1  - Islam, Nazrul
A1  - Martínez Morales, Miguel Ángel
A1  - Alonso Alomá, Ismell
A1  - Achiong Estupiñan, Fernando
A1  - Díaz González, Mayda
A1  - Rosquete Muñoz, Noel
A1  - Cendra Asencio, Marelis
A1  - Emberson, Jonathan
A1  - Peto, Richard
A1  - Lewington, Sarah
SP  - 100692
EP  - 100692
VL  - 33
IS  - 
N2  - BACKGROUND: The associations of cause-specific mortality with alcohol consumption have been studied mainly in higher-income countries. We relate alcohol consumption to mortality in Cuba. <br><br>METHODS: In 1996-2002, 146 556 adults were recruited into a prospective study from the general population in five areas of Cuba. Participants were interviewed, measured and followed up by electronic linkage to national death registries until January 1, 2017. After excluding all with missing data or chronic disease at recruitment, Cox regression (adjusted for age, sex, province, education, and smoking) was used to relate mortality rate ratios (RRs) at ages 35-79 years to alcohol consumption. RRs were corrected for long-term variability in alcohol consumption using repeat measures among 20 593 participants resurveyed in 2006-08. <br><br>FINDINGS: After exclusions, there were 120 623 participants aged 35-79 years (mean age 52 [SD 12]; 67 694 [56%] women). At recruitment, 22 670 (43%) men and 9490 (14%) women were current alcohol drinkers, with 15 433 (29%) men and 3054 (5%) women drinking at least weekly; most alcohol consumption was from rum. All-cause mortality was positively and continuously associated with weekly alcohol consumption: each additional 35cl bottle of rum per week (110g of pure alcohol) was associated with ∼10% higher risk of all-cause mortality (RR 1.08 [95%CI 1.05-1.11]). The major causes of excess mortality in weekly drinkers were cancer, vascular disease, and external causes. Non-drinkers had ∼10% higher risk (RR 1.11 [1.09-1.14]) of all-cause mortality than those in the lowest category of weekly alcohol consumption (<1 bottle/week), but this association was almost completely attenuated on exclusion of early follow-up. <br><br>INTERPRETATION: In this large prospective study in Cuba, weekly alcohol consumption was continuously related to premature mortality. Reverse causality is likely to account for much of the apparent excess risk among non-drinkers. The findings support limits to alcohol consumption that are lower than present recommendations in Cuba. FUNDING: Medical Research Council, British Heart Foundation, Cancer Research UK, CDC Foundation (with support from Amgen).<p />  <p>Language: en</p>
LA  - en
SN  - 2589-5370
UR  - http://dx.doi.org/10.1016/j.eclinm.2020.100692
ID  - ref1
ER  -