Alcohol drinking linked to death, MACE among veterans

Alcohol consumption contributes to increased mortality and major adverse cardiovascular events (MACE) among US veterans, with a J-shaped association indicating reduced risk at moderate consumption levels compared with abstinence of heavier drinking, suggests a study.

"However, alcohol consumption demonstrates a linear dose–response relationship with cancers, with increased risks for alcohol-related cancers even at moderate consumption levels,” the investigators said. “The alcohol and head and neck cancer association was significantly exacerbated by smoking.”

In this study, the investigators collected self-reported alcohol consumption from 438,442 participants from the prospective Million Veteran Program Study (MVP 2011–2024). They examined outcomes, including total mortality, incident cancer, and MACE.

Alcohol consumption showed a J-shaped association with the risk of mortality (p<0.0001 for both linear trend and curvature) and the risk of MACE (p<0.0001 for curvature and p=0.24 for linear trend).

Compared with never drinkers, current drinkers with alcohol intake of 0.1–30 g/day had a hazard ratio (HR) of 0.86 (95 percent confidence interval [CI], 0.84–0.89) for mortality and 0.84 (95 percent CI, 0.80–0.89) for MACE.

Furthermore, the risk of cancer positively correlated with higher daily intake among current drinkers (0.1–30 g/day: HR, 1.03, 95 percent CI, 0.99–1.17; 31–60 g/day: HR, 1.06, 95 percent CI, 1.00–1.12; 61–90 g/day: HR, 1.20, 95 percent CI, 1.12–1.29; ≥90 g/day: HR, 1.28, 95 percent CI, 1.12–1.47; p=0.06 for curvature and p<0.0001 for linear trend).

Notably, the risk for head and neck cancer was significantly higher among current smokers with moderate alcohol consumption (females ≤14 g/day and males ≤28 g/day; HR, 3.21, 95 percent CI, 2.17–4.74) and current smokers with heavy drinking (HR, 5.69, 95 percent CI, 3.76–8.62; p=0.03 for interaction) than those who reported never smoking and never drinking.