The relationship between different dimensions of alcohol use and the burden of disease—an update

Rehm, Jürgen; Gmel, Gerhard; Gmel, Gerrit; Hasan, Omer Syed Muhammad; Imtiaz, Sameer; Popova, Svetlana; Probst, Charlotte; Roerecke, Michael; Room, Robin; Samokhvalov, Andriy V.; Shield, Kevin D.; Shuper, Paul A.

doi:10.1111/add.13757

Cited by 791 publications

(675 citation statements)

References 348 publications

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“…On the one side, low‐level drinking has been associated with less risk for ischemic heart disease69, 70; on the other side, the risk for hypertension seems increased, at least in men. In order to side with caution, patients should be advised to drink as little as possible for many reasons, including increased risk of cancer and injury, to name a few,15 and the risk of hypertension should be added to the list of diseases where no alcohol consumption is safe. This may require a change in drinking advice in current guidelines for prevention and treatment of hypertension, which state that men should limit their alcohol intake to 2 drinks or less, a level which we found to be associated with increased risk for hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies since then have confirmed the association between heavy drinking and development of hypertension 10. However, the association between light‐to‐moderate drinking and hypertension is still disputed,11, 12 despite a number of meta‐analyses13, 14 and countless reviews (overview of recent reviews15). The association may also depend on sex, which could be related to differential alcohol metabolism16 or drinking patterns 17…”

Section: Introductionmentioning

confidence: 99%

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Sex‐Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta‐Analysis of Cohort Studies

Roerecke

Tobe

Kaczorowski

et al. 2018

JAHA

Self Cite

119

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BackgroundAlthough it is well established that heavy alcohol consumption increases the risk of hypertension, the risk associated with low levels of alcohol intake in men and women is unclear.Methods and ResultsWe searched Medline and Embase for original cohort studies on the association between average alcohol consumption and incidence of hypertension in people without hypertension. Random‐effects meta‐analyses and metaregressions were conducted. Data from 20 articles with 361 254 participants (125 907 men and 235 347 women) and 90 160 incident cases of hypertension (32 426 men and 57 734 women) were included. In people drinking 1 to 2 drinks/day (12 g of pure ethanol per drink), incidence of hypertension differed between men and women (relative riskwomen vs men=0.79; 95% confidence interval, 0.67–0.93). In men, the risk for hypertension in comparison with abstainers was relative risk=1.19 (1.07–1.31; I2=59%), 1.51 (1.30–1.76), and 1.74 (1.35–2.24) for consumption of 1 to 2, 3 to 4, and 5 or more standard drinks per day, respectively. In women, there was no increased risk for 1 to 2 drinks/day (relative risk=0.94; 0.88–1.01; I2=73%), and an increased risk for consumption beyond this level (relative risk=1.42; 1.22–1.66).ConclusionsAny alcohol consumption was associated with an increase in the risk for hypertension in men. In women, there was no risk increase for consumption of 1 to 2 drinks/day and an increased risk for higher consumption levels. We did not find evidence for a protective effect of alcohol consumption in women, contrary to earlier meta‐analyses.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sex‐Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta‐Analysis of Cohort Studies

Roerecke

Tobe

Kaczorowski

et al. 2018

JAHA

Self Cite

119

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“…Alcohol dependence considered to be a multifactorial disorder occurs due to various gene-gene and gene-environment interactions [1,5]. Numerous genetic association studies have been conducted to determine polymorphisms in genes of the dopamine pathway [2,[38][39][40][41][42][43][44][45][46][47][48][49][50][51].…”

Section: Discussionmentioning

confidence: 99%

“…Alcohol dependence (AD) has emerged as a major social and health problem globally and is responsible for high mortality and morbidity [1]. Several studies report on the genetic predisposition to alcohol dependence, although this does not deny the role of environmental factors [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

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An Association Study of the COMT and GABA Gene Variants with Alcohol Dependence

Singh¹,

Grover²,

Gupta³

et al. 2017

J Addict Res Ther

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Alcohol dependence (AD), associated with high mortality and morbidity is caused due to involvement of both environmental and genetic factors. Behavioral effects of alcohol including cognitive impairment, motor incoordination, tolerance and dependence are likely due to its effect on the multiple brain proteins including neurotransmitters. Dysfunction in these neurotransmitter systems may be at the level of enzymes involved in metabolic degradation, or receptors involved in neurotransmission like dopamine, Gamma-amino butyric acid (GABA), serotonin etc. Genetic polymorphisms in these neurotransmitter systems are implicated in conferring susceptibility to AD. Aim:To identify association of single nucleotide polymorphisms (SNPs) in COMT (rs4680 and rs2075507) and GABAA receptor genes (rs13172914 and rs211014) with AD.Method: A total of 100 AD patients diagnosed on the basis of DSM IV criteria from the outpatient clinic of the National Drug Dependence Treatment Centre (NDDTC) of All India Institute of Medical Sciences (AIIMS), and 100 healthy individuals from the general population were recruited. A detailed history including pattern of drug use and demographic details with pedigree information was noted. Genomic DNA from peripheral blood samples was processed for PCR amplification followed by restriction digestion to screen for the presence of polymorphisms. Genotype and allele frequencies were evaluated and correlated with alcohol use parameters including duration of alcohol use, age at onset of alcohol use, quantity of alcohol consumed (gms/day) and WHO ASSIST score and levels of liver function enzymes (SGPT and SGOT). Statistical analysis was performed using SPSS v21.0.Results: Genetic analysis of the study group revealed COMT rs4680 to be significantly associated with AD (p=0.03), while the other COMT SNP rs2075507 showed an association with increased levels of SGPT in the patients. GABAA receptor gene polymorphisms showed no association with AD. Conclusion:The study suggests a role of COMT gene polymorphism rs4680 in conferring susceptibility to AD.

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Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults

O’Connor

Perdue

Senger

et al. 2018

JAMA

167

211

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IMPORTANCE Unhealthy alcohol use is common, increasing, and a leading cause of premature mortality. OBJECTIVE To review literature on the effectiveness and harms of screening and counseling for unhealthy alcohol use to inform the US Preventive Services Task Force. DATA SOURCES MEDLINE, PubMed, PsycINFO, and the Cochrane Central Register of Controlled Trials through October 12, 2017; literature surveillance through August 1, 2018.STUDY SELECTION Test accuracy studies and randomized clinical trials of screening and counseling to reduce unhealthy alcohol use.DATA EXTRACTION AND SYNTHESIS Independent critical appraisal and data abstraction by 2 reviewers. Counseling trials were pooled using random-effects meta-analyses.MAIN OUTCOMES AND MEASURES Sensitivity, specificity, drinks per week, exceeding recommended limits, heavy use episodes, abstinence (for pregnant women), and other health, family, social, and legal outcomes. RESULTSOne hundred thirteen studies (N = 314 466) were included. No studies examined benefits or harms of screening programs to reduce unhealthy alcohol use. For adolescents (10 studies [n = 171 363]), 1 study (n = 225) reported a sensitivity of 0.73 (95% CI, 0.60 to 0.83) and specificity of 0.81 (95% CI, 0.74 to 0.86) using the AUDIT-C (Alcohol Use Disorders Identification Test-Consumption) to detect the full spectrum of unhealthy alcohol use. For adults (35 studies [n = 114 182]), brief screening instruments commonly reported sensitivity and specificity between 0.70 and 0.85. Two trials of the effects of interventions to reduce unhealthy alcohol use in adolescents (n = 588) found mixed results: one reported a benefit in high-risk but not moderate-risk drinkers, and the other reported a statistically significant reduction in drinking frequency for boys but not girls; neither reported health or related outcomes. Across all populations (68 studies [n = 36 528]), counseling interventions were associated with a decrease in drinks per week (weighted mean difference, −1.6 [95% CI, −2.2 to −1.0]; 32 studies [37 effects; n = 15 974]), the proportion exceeding recommended drinking limits (odds ratio [OR], 0.60 [95% CI, 0.53 to 0.67]; 15 studies [16 effects; n = 9760]), and the proportion reporting a heavy use episode (OR, 0.67 [95% CI, 0.58 to 0.77]; 12 studies [14 effects; n = 8108]), and an increase in the proportion of pregnant women reporting abstinence (OR, 2.26 [95% CI, 1.43 to 3.56]; 5 studies [n = 796]) after 6 to 12 months. Health outcomes were sparsely reported and generally did not demonstrate group differences in effect. There was no evidence that these interventions could be harmful.CONCLUSIONS AND RELEVANCE Among adults, screening instruments feasible for use in primary care are available that can effectively identify people with unhealthy alcohol use, and counseling interventions in those who screen positive are associated with reductions in unhealthy alcohol use. There was no evidence that these interventions have unintended harmful effects.Additionally, for the outcome drinks per week, whic...

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The relationship between different dimensions of alcohol use and the burden of disease—an update

Cited by 791 publications

References 348 publications

Sex‐Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta‐Analysis of Cohort Studies

Sex‐Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta‐Analysis of Cohort Studies

An Association Study of the COMT and GABA Gene Variants with Alcohol Dependence

Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults

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