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Armas Rojas NB, Lacey B, Simadibrata DM, et al. Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults. EClinicalMedicine. 2021;33:100692doi: 10.1016/j.eclinm.2020.100692.
Armas Rojas, N. B., Lacey, B., Simadibrata, D. M., Ross, S., Varona-Pérez, P., Burrett, J. A., Calderón Martínez, M., Lorenzo-Vázquez, E., Bess Constantén, S., Thomson, B., Sherliker, P., Morales Rigau, J. M., Carter, J., Massa, M. S., Hernández López, O. J., Islam, N., Martínez Morales, M. �. �., Alonso Alomá, I., Achiong Estupiñan, F., Díaz González, M., Rosquete Muñoz, N., Cendra Asencio, M., Emberson, J., Peto, R., & Lewington, S. (2021). Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults. EClinicalMedicine, 33100692. https://doi.org/10.1016/j.eclinm.2020.100692
Armas Rojas, Nurys B, et al. "Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults." EClinicalMedicine vol. 33 (2021): 100692. doi: https://doi.org/10.1016/j.eclinm.2020.100692
Armas Rojas NB, Lacey B, Simadibrata DM, Ross S, Varona-Pérez P, Burrett JA, Calderón Martínez M, Lorenzo-Vázquez E, Bess Constantén S, Thomson B, Sherliker P, Morales Rigau JM, Carter J, Massa MS, Hernández López OJ, Islam N, Martínez Morales MÁ, Alonso Alomá I, Achiong Estupiñan F, Díaz González M, Rosquete Muñoz N, Cendra Asencio M, Emberson J, Peto R, Lewington S. Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults. EClinicalMedicine. 2021 Mar 17;33:100692. doi: 10.1016/j.eclinm.2020.100692. eCollection 2021 Mar. PMID: 33768200; PMCID: PMC7980059.
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EClinicalMedicine. 2021 Mar 17;33:100692. doi: 10.1016/j.eclinm.2020.100692. eCollection 2021 Mar.

Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults.

EClinicalMedicine

Nurys B Armas Rojas, Ben Lacey, Daniel Martin Simadibrata, Stephanie Ross, Patricia Varona-Pérez, Julie Ann Burrett, Marcy Calderón Martínez, Elba Lorenzo-Vázquez, Sonia Bess Constantén, Blake Thomson, Paul Sherliker, José Manuel Morales Rigau, Jennifer Carter, M Sofia Massa, Osvaldo Jesús Hernández López, Nazrul Islam, Miguel Ángel Martínez Morales, Ismell Alonso Alomá, Fernando Achiong Estupiñan, Mayda Díaz González, Noel Rosquete Muñoz, Marelis Cendra Asencio, Jonathan Emberson, Richard Peto, Sarah Lewington

Affiliations

  1. National Institute of Cardiology and Cardiovascular Surgery, Havana, Cuba.
  2. Nuffield Department of Population Health (NDPH), University of Oxford, UK.
  3. Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
  4. Institute of Hygiene, Epidemiology and Microbiology, Ministry of Public Health, Havana, Cuba.
  5. Cuban Commission Against Smoking, Ministry of Public Health, Havana, Cuba.
  6. Directorate of Medical Records and Health Statistics, Ministry of Public Health, Havana, Cuba.
  7. George Institute for Global Health, University of Oxford, UK.
  8. MRC Population Health Research Unit, NDPH, University of Oxford, UK.
  9. Provincial Center of Hygiene, Epidemiology and Microbiology, Matanzas, Cuba.
  10. Municipal Center of Hygiene, Epidemiology and Microbiology, Jagüey Grande, Matanzas, Cuba.
  11. Municipal Center of Hygiene, Epidemiology and Microbiology, Colón, Matanzas, Cuba.
  12. Municipal Center of Hygiene, Epidemiology and Microbiology, Camagüey, Cuba.
  13. UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

PMID: 33768200 PMCID: PMC7980059 DOI: 10.1016/j.eclinm.2020.100692

Abstract

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.

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.

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.

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).

© 2021 The Authors.

Keywords: Alcohol; Cuba; Mortality; Prospective study

Conflict of interest statement

SL reports grants from the Medical Research Council (MRC) during the conduct of the study, and research funding from the US Centers for Disease Control and Prevention Foundation (with support from Amg

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