Recently, time-series correlations of aggregated data have been used to demonstrate the length of latency periods for environmental factors, such as economic conditions and alcohol consumption, in influencing heart disease mortality. Latency periods were specified by lagging mortality rates relative to the economic indicators or rates of alcohol consumption until the highest correlations were achieved. The tendency has been to interpret these correlations without regard to whether the latency periods described are biologically plausible. The authors have identified four models which represent all the possible outcomes of correlational studies of time-series data. Using United States and Canadian mortality rates in relationship to alcohol consumption, they have demonstrated the application of each of these models. For three of the four models, the time-series (lag) correlations are uniform regardless of the number of years mortality is lagged relative to alcohol consumption, and this uniformity does not permit a latency period to be identified. Only the lag correlations between two nonlinear variables show variations over time, depending on the degree of correspondence between the increasing and decreasing line segments of the two curves. Correlations ranging from high positive to high negative are possible, and several peak correlations (positive and negative) can occur. However, the biologic interpretation of multiple peaks with the same or different signs is problematic. The authors conclude that time-series correlations of aggregated data are not useful for the study of latency periods, and that analysis of time-series correlations for this purpose can be at best ambiguous, and at worst, completely misleading.
The association between consumption of alcoholic beverages (spirits, beer and wine) and coronary heart disease (CHD) mortality, especially the incidence of sudden coronary death (SCD), was investigated in a 5-year prospective population study comprising 4,532 men aged 40-64 years. The amount of alcohol used was estimated on the basis of answers to a self-filled structured questionnaire. The incidence of SCD was statistically significantly lower among abstainers than among alcohol consumers. The relative risk of SCD of alcohol consumers in comparison with abstainers was largest in the oldest age group and it became more apparent after a follow-up of a couple of years. Only the consumption of spirits was positively associated with the incidence of SCD. Among non-smokers the incidence of SCD was statistically significantly higher in consumers than in abstainers, a similar but not significant trend was observed among current smokers. The positive association between alcohol consumption and incidence of SCD was detected both in CHD-free men and in men with prior CHD. Consumption of alcoholic beverages, and in particular of spirits, is associated with an increased risk of SCD in Finnish men.
The method of dietetic interview was used in a strictly standardized epidemiological investigation of a random sample of males aged from 30 to 59 years (n-2537) in Kiev. A dependence has been revealed between the use of alcohol and disorders in the character of nutrition unfavourable in respect to coronary heart disease. A relationship has been established between the alcohol use and the incidence rate of such risk factors of coronary heart disease as hyperlipoproteinemia, excessive body mass, smoking, and the incidence of myocardial infarction. No relationship was recorded between alcohol kind and dose and the incidence of risk factors of coronary heart disease.
High alcohol consumption is one of the major risk indicators for premature death in middle-aged men. An indicator of alcohol abuse--registration with the social authorities for alcoholic problems--was used to evaluate the role of alcohol in relation to general and cause-specific mortality in a general population sample. Altogether 1,116 men (11%) out of a total population of 10,004 men were registered for alcoholic problems. Total mortality during 11.8 years' follow-up was 10.4% among the non-registered men, compared to 20.5% among men with occasional convictions for drunkenness and 29.6% among heavy abusers. Fatal cancer as a whole was not independently associated with alcohol abuse, but oropharyngeal and oesophageal cancers together were seven times more common in the alcohol-registered groups. Total coronary heart disease (CHD) was significantly and independently associated with alcohol abuse, but nearly all the excess CHD mortality among the alcohol-registered men could be attributed to sudden coronary death. Cases with definite recent myocardial infarction were not more common in the alcoholic population. A combined effect of coronary arteriosclerosis and heart muscle damage secondary to alcohol abuse is suggested. Other causes of death strongly associated with registration for alcohol abuse include pulmonary embolism, pneumonia and peptic ulcer, as well as death from liver cirrhosis and alcoholism. Of the excess mortality among alcohol-registered subjects, 20.1% could be attributed to CHD, 18.1% to violent death, 13.6% to alcoholism without another diagnosis and 11.1% to liver cirrhosis.
Ten years after a health screening examination was offered to 50 year old men 32 of the 2322 participants and 12 of the 454 nonparticipants had died of ischaemic heart disease. Of these, 26 and 11 respectively had suffered sudden death, for which necropsy was performed. Half of the men who had died suddenly had been registered for alcohol intemperance up to 1973, which was four times the prevalence of such registrations in the general population. Registration at both the Swedish Temperance Board and the Bureau of Social Services was associated with an odds ratio of 3.74 for sudden death as compared with not being registered at either. Logistic analysis including the classical risk factors for ischaemic heart disease together with registration for alcohol intemperance and at the Bureau of Social Services showed only the two types of registration and systolic blood pressure to be independent risk factors. On the other hand, there was no overrepresentation of subjects entered in the registers among those surviving a myocardial infarction. For non-fatal myocardial infarction blood pressure and serum triglyceride concentration were significant risk factors and serum cholesterol concentration, smoking, and body mass index probable risk factors; the two types of registration were not independent risk factors. Alcohol intemperance is strongly associated with an increased risk of sudden death after myocardial infarction.
Mass examination in organized populations at industrial enterprises made it possible to bring to light a statistically significant different effect of the level of productive labor and sport activity on the prevalence of frequent alcohol consumption as one of CHD risk factors. A sufficient degree of regular physical training made a considerable effect on a decrease in CHD prevalence.
