Associations Between Medical Conditions and Alcohol Consumption Levels in an Adult Primary Care Population

Sterling, Stacy; Palzes, Vanessa A.; Lu, Yun; Kline-Simon, Andrea H.; Parthasarathy, Sujaya; Ross, Thekla B.; Elson, Joseph; Weisner, Constance; Maxim, Clara; Felicia, W.

doi:10.1001/jamanetworkopen.2020.4687

Cited by 62 publications

(63 citation statements)

References 62 publications

(81 reference statements)

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“…Specifically, patients with schizophrenia and schizoaffective disorder were about 5 times as likely as those without to report no alcohol use, while patients with depression and anxiety disorder were only slightly more likely than those without to report no alcohol use. These findings are more similar to our prior study showing that individuals with a range of chronic medical conditions were more likely to report no alcohol use (Sterling et al, 2020) and other studies revealing a U‐shaped (or J‐shaped) relationship between alcohol consumption and health status [including all‐cause mortality (Shaper et al, 1988) and type 2 diabetes (Koppes et al, 2005)], suggesting that individuals in ill health may quit drinking. In the present study, patients with psychiatric disorders, particularly more serious ones, may find that alcohol exacerbates their symptoms (e.g., affective lability) or is contraindicated with medication they are taking, or they could have been advised to limit alcohol use by their care team, and thus chose not to drink.…”

Section: Discussionsupporting

confidence: 90%

Associations Between Psychiatric Disorders and Alcohol Consumption Levels in an Adult Primary Care Population

Palzes

Parthasarathy

Felicia

et al. 2020

Alcoholism Clin & Exp Res

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Background: Unhealthy alcohol use frequently co-occurs with psychiatric disorders; however, little is known about the relationship between psychiatric disorders and alcohol consumption levels. Understanding varying levels of unhealthy alcohol use among individuals with a variety of psychiatric disorders in primary care would provide valuable insight for tailoring interventions. Methods: We conducted a cross-sectional study of 2,720,231 adult primary care patients screened for unhealthy alcohol use between 2014 and 2017 at Kaiser Permanente Northern California, using electronic health record data. Alcohol consumption level was classified as no reported use, low-risk use, and unhealthy use, per National Institute on Alcohol Abuse and Alcoholism guidelines. Unhealthy use was further differentiated into mutually exclusive groups: exceeding only daily limits, exceeding only weekly limits, or exceeding both daily and weekly limits. Multivariable multinomial logistic regression models were fit to examine associations between 8 past-year psychiatric disorders (depression, bipolar disorder, anxiety disorder, obsessive-compulsive disorder, schizophrenia, schizoaffective disorder, anorexia nervosa, and bulimia nervosa) and alcohol consumption levels, adjusting for sociodemographic and health characteristics. Results: In the full sample [53% female, 48% White, mean (SD) age = 46 (18) years], patients with psychiatric disorders (except eating disorders), compared to those without, had lower odds of reporting low-risk and unhealthy alcohol use relative to no use. Among patients who reported any alcohol use (n = 861,427), patients with depression and anxiety disorder, compared to those without, had higher odds of exceeding only weekly limits and both limits; patients with bulimia nervosa were also more likely to exceed both limits. Conclusions: Findings suggest that patients with anxiety disorder, depression, and bulimia nervosa who drink alcohol are more likely to exceed recommended limits, increasing risk of developing more serious problems. Health systems and clinicians may wish to consider implementing more robust screening, assessment, and intervention approaches to support these vulnerable subgroups in limiting their drinking.

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Section: Discussionsupporting

confidence: 90%

Associations Between Psychiatric Disorders and Alcohol Consumption Levels in an Adult Primary Care Population

Palzes

Parthasarathy

Felicia

et al. 2020

Alcoholism Clin & Exp Res

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“…It is not yet clear whether pulmonary arterial hypertension is a risk factor for severe COVID-19 ( Farha, 2020 ) although management of PAH in the context of coronavirus infection is a concern ( Ryan et al, 2020 ). As with several chronic disease states, excessive alcohol consumption is associated with hypertension ( Sterling et al, 2020 ). The intersection of alcohol, COVID-19 and pulmonary hypertension remains to be explored.…”

Section: Auds and Lung Diseasementioning

confidence: 99%

Alcohol use disorder: A pre-existing condition for COVID-19?

Bailey

Samuelson

Wyatt

2021

Alcohol

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Alcohol misuse is long established as a contributor to the pathophysiology of the lung. The intersection of multi-organ responses to alcohol-mediated tissue injury likely contributes to the modulation of lung in response to injury. Indeed, the negative impact of alcohol on susceptibility to infection and on lung barrier function is now well documented. Thus, the alcohol lung represents a very likely comorbidity for the negative consequences of both COVID-19 susceptibility and severity. In this review, we present the known alcohol misuse ramifications on the lung in the context of the current coronavirus pandemic.

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“…In a cross-sectional study comprising more than 2.7 million adult primary care patients, unhealthy alcohol consumption was communicated in 269,379 subjects, with higher odds of exceeding daily and weekly recommended amounts recorded among hypertensive subjects [ 45 ].…”

Section: Alcohol Intake and Elevated Blood Pressurementioning

confidence: 99%

Consensus and Controversy in the Debate over the Biphasic Impact of Alcohol Consumption on the Cardiovascular System

et al. 2021

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In the past few decades, research has focused on the importance of addressing modifiable risk factors as a means of lowering the risk of cardiovascular disease (CVD), which represents the worldwide leading cause of death. For quite a long time, it has been considered that ethanol intake has a biphasic impact on the cardiovascular system, mainly depending on the drinking pattern, amount of consumption, and type of alcoholic beverage. Multiple case-control studies and meta-analyses reported the existence of a “U-type” or “J-shaped” relationship between alcohol and CVD, as well as mortality, indicating that low to moderate alcohol consumption decreases the number of adverse cardiovascular events and deaths compared to abstinence, while excessive alcohol use has unquestionably deleterious effects on the circulatory system. However, beginning in the early 2000s, the cardioprotective effects of low doses of alcohol were abnegated by the results of large epidemiological studies. Therefore, this narrative review aims to reiterate the association of alcohol use with cardiac arrhythmias, dilated cardiomyopathy, arterial hypertension, atherosclerotic vascular disease, and type 2 diabetes mellitus, highlighting literature disagreements over the risk and benefits of low to moderate drinking on the cardiovascular system.

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Associations Between Medical Conditions and Alcohol Consumption Levels in an Adult Primary Care Population

Cited by 62 publications

References 62 publications

Associations Between Psychiatric Disorders and Alcohol Consumption Levels in an Adult Primary Care Population

Associations Between Psychiatric Disorders and Alcohol Consumption Levels in an Adult Primary Care Population

Alcohol use disorder: A pre-existing condition for COVID-19?

Consensus and Controversy in the Debate over the Biphasic Impact of Alcohol Consumption on the Cardiovascular System

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