Alcohol and Mortality in British Men: Explaining the U-Shaped Curve

Shaper, A. G.; Wannamethee, Goya; Walker, Mary

doi:10.1016/s0140-6736(88)92890-5

Cited by 701 publications

(472 citation statements)

References 29 publications

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“…The estimated relative risk was fourfold, similar to or stronger than the relative risk of overall mortality in drinkers (29,30). Several possible pathogenic pathways may relate alcohol consumption to chronic kidney failure.…”

Section: Alcohol Consumption As a Risk Factor For Esrdmentioning

confidence: 66%

Risk of End-stage Renal Disease Associated with Alcohol Consumption

Perneger

Whelton

Puddey

et al. 1999

American Journal of Epidemiology

115

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Alcohol consumption has been linked to kidney disorders in selected patient groups, but whether it contributes to the burden of end-stage renal disease (ESRD) in the general population is unknown. The authors conducted a population-based case-control study to assess the relation between alcohol consumption and risk of ESRD. The study took place in Maryland, Virginia, West Virginia, and Washington, DC, in 1991. Participants were 716 patients who had started treatment for ESRD and 361 control subjects of similar age (20-64 years) selected by random digit dialing. The main risk factor of interest was self-reported consumption of alcoholic beverages (frequency of drinking days and number of drinks consumed per drinking day). In univariate analysis, consumption of alcohol exhibited a J-shaped association with risk of ESRD. The J shape disappeared after exclusion of persons who had ever consumed home-distilled whiskey ("moonshine") and adjustment for age, race, sex, income, history of hypertension, history of diabetes mellitus, use of acetaminophen, use of opiates, and cigarette smoking; however, the odds ratio for ESRD remained significantly increased (odds ratio = 4.0; 95% confidence interval: 1.2, 13.0) among persons who consumed an average of >2 alcoholic drinks per day. The corresponding population attributable risk was 9 percent. Thus, consumption of more than two alcoholic drinks per day, on average, was associated with an increased risk of kidney failure in the general population. A lower intake of alcohol did not appear to be harmful. Because these results are based on self-reports in a case-control study, they should be seen as preliminary. Am J Epidemiol 1999;150:1275-81. alcohol drinking; ethanol; kidney failure, chronic Prevention of end-stage renal disease (ESRD) requires knowledge of modifiable risk factors responsible for initiation and promotion of renal insufficiency (1). Modifiable risk factors for kidney failure that have been identified in population-based studies include high blood pressure (2), diabetes mellitus (3), exposure to occupational nephrotoxins (4), and chronic use of analgesics (5). However, known risk factors explain only a limited part of the overall incidence of ESRD.Alcohol consumption is a plausible risk factor for ESRD. Historically, alcoholism or intemperance was suspected of causing kidney failure by Richard Bright

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Section: Alcohol Consumption As a Risk Factor For Esrdmentioning

confidence: 66%

Risk of End-stage Renal Disease Associated with Alcohol Consumption

Perneger

Whelton

Puddey

et al. 1999

American Journal of Epidemiology

115

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“…Th e lack of primary prophylaxis could result from the patients ' unawareness of illness or refusal of referral by the primary physician. Patients with an awareness of illness might be more likely to reduce or stop drinking than other patients ( 37 ). Th ese fi ndings emphasize the detrimental eff ects of excessive drinking on EV bleeding.…”

Section: Conflict Of Interestmentioning

confidence: 83%

Potential Precipitating Factors of Esophageal Variceal Bleeding: A Case–Control Study

Liao

Hou

Chang

et al. 2011

American Journal of Gastroenterology

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Valsalva maneuver-associated activities such as straining during defecation, vomiting, and cough are believed to cause abrupt increase in variceal pressure. Whether these actions can precipitate rupture of esophageal varices (EV) is unknown. The association of EV bleeding with these activities and other potential risk factors such as ingestion of alcohol and non-steroidal anti-infl ammatory drugs was investigated. METHODS:Between January 2003 and May 2009, 240 patients with liver cirrhosis and acute EV bleeding (group A) and 240 matched patients with Child-Pugh ' s class and moderate size EV without bleeding (group B) were included. Each patient was questioned regarding constipation, vomiting, cough, and other potential risk factors in the week prior to index bleeding (group A) or endoscopy (group B) using a standard questionnaire. RESULTS:Group A had more patients with constipation ( n = 44 vs. n = 16, P < 0.001) and higher constipation scores (0.79 ± 1.67 vs. 0.25 ± 0.92, P < 0.001) than group B. Group A also had more patients with vomiting ( n = 60 vs. n = 33, P = 0.002) and higher vomiting scores (3.0 ± 0.86 vs. 1.85 ± 0.87, P < 0.001). No difference in cough existed between the two groups ( n = 77 group A vs. n = 73 group B); however, group A had higher cough scores (5.08 ± 2.70 vs. 3.19 ± 2.23, P < 0.001). Group A had more patients with excessive alcohol consumption in the week preceding inclusion in the study ( n = 58 vs. n = 5, P < 0.001). On multivariate analysis, constipation score and vomiting score and alcohol consumption were independent determinants of fi rst EV bleeding.CONCLUSIONS: Constipation, vomiting, severe coughing, and excessive consumption of alcohol may precipitate rupture of EV. A prospective cohort study is required to clarify the causal relationship between potential precipitating factors and EV bleeding.

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“…18,19 Although the observed higher morbidity in later life of teetotallers may be due to a protective effect of alcohol on high BP, an alternative possibility is that it may be due to abstinence in previous alcohol abusers or as a result of behaviour change following diagnosis of disease. 20 In this study alcohol intake was recorded prior to the onset of adult disease and hence confounding due to comorbidity is unlikely. The measurement of alcohol consumption in this study was crude, being categorised as 'none', 'occasional' or 'regular', which may partially explain the observed results.…”

Section: Discussionmentioning

confidence: 99%