Great to see the latest big paper from @Cambridge_CEU @DPHPC out in @TheLancet investigating the associations of alcohol consumption with cardiovascular disease, mortality and life expectancy: thelancet.com/journals/lance… 1/N
Limits in alcohol guidelines vary widely around the world and previous studies have suggested J-shaped associations of alcohol intake with CVD, leading to the popular notion that moderate drinking is "good for the heart" 2/
We studied 600,000 people without CVD from 83 studies in the ERFC, EPIC-CVD and @uk_biobank who were all 'current drinkers' at baseline (to minimise biases from including ex/never drinkers). 40K deaths and 40K CVD events were recorded. 3/
Main take-homes were: 1) higher risk of all-cause mortality begins at ~100g per week, equivalent to ~12.5units (5-6 pints of beer / glasses of wine in UK), suggesting limits in many countries should be reduced 4/ 
2) Men drinking above the US limit (196g/week) live 1.6 years shorter than those drinking below 100g/week; equivalent for women is 1.3 years. 5/
3) J-shaped relationship with total CVD comes from weak inverse association with non-fatal heart attack but positive broadly linear associations with most other CVD subtypes. 6/
4) Although this observational study can't prove causal relationships (wait for results of mach15trial.org for that), evidence supports lower limits such as those in the UK 7/
More detailed investigation needed to understand opposing associations of alcohol intake with non-fatal heart attacks vs other CVD events: blood pressure and HDL-c the only factors included that seem to influence the results 8/
Suggestions that adverse associations worse for beer and spirits compared to wine, but potential for confounding higher for these analyses. Little heterogeneity or evidence for differences across subgroups. 9/
Caveats: self-reported alcohol measures; no information on drinking patterns or lifetime drinking history (although analyses corrected for regression dilution); studies from 19 high-income countries, different in lower income countries? 10/
Enormous effort over many years made possible by funding from @TheBHF @The_MRC @ERC_Research @EU_Health (& many others) and efforts of dozens of investigators over many years, especially Angela Wood. 11/
Enjoy reading in more detail with a glass of wine 🍷, but maybe just the one! 12/12
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