PROSPECTIVE-STUDY OF MODERATE ALCOHOL-CONSUMPTION AND MORTALITY IN USMALE PHYSICIANS

Background: Although moderate alcohol consumption decreases the risk o f myocardial infarction, its impact on all-cause mortality among appar ently healthy men is unclear. Methods: We performed a prospective coho rt study in 22 071 men in the Physicians' Health Study. Participants w ere aged 40 to 84 years and had no history of myocardial infarction, s troke, transient ischemic attack, or cancer. Results: There were 1206 deaths (394 cardiovascular, 488 cancer, and 324 other) during 10.7 yea rs of followup. Compared with participants who consumed less than 1 dr ink per week, the relative risk (95% confidence interval) of all-cause mortality for men who consumed 2 to 4 drinks per week was 0.72 (0.59- 0.87); 5 to 6 drinks per week, 0.79 (0.64-0.99); 1 drink per day, 0.98 (0.84-1.15); and the highest drinking group (greater than or equal to 2 drinks per day), 1.51 (1.17-1.95). This association was similar wit h either nondrinkers or occasional drinkers used as the reference grou p and was not subject to material confounding or effect modification b y any factor examined. The overall relationship was the result of a J- shaped association with cardiovascular mortality, an increase in cance r deaths for the highest drinking group, and a U-shaped association wi th other causes of mortality. Conclusions: Risk of all-cause mortality varies by level of alcohol consumption. In this apparently healthy co hort, men who consumed 2 to 6 drinks per week had the most favorable m ortality profile and men who had 2 or more drinks per day the most unf avorable mortality profile. The difference between consumption of smal l and large amounts of alcohol may mean the difference between prevent ing and causing excess mortality.