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Article: Alcohol and cardio-respiratory deaths in Chinese: A population-based case-control study of 32,462 older Hong Kong adults

TitleAlcohol and cardio-respiratory deaths in Chinese: A population-based case-control study of 32,462 older Hong Kong adults
Authors
Issue Date2009
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcpublichealth/
Citation
Bmc Public Health, 2009, v. 9 How to Cite?
AbstractBackground: In observational studies moderate alcohol use reduces cardio-respiratory mortality. However observational studies may be biased by many factors including residual confounding by unmeasured differences between moderate alcohol users and other groups or by changes in alcohol use with ill-health and aging. We used two different analytic strategies in an under-studied population, i.e. southern Chinese, to provide an assessment of the specific impact of moderate alcohol use on mortality from ischemic heart disease (IHD) and chronic obstructive pulmonary diseases (COPD). Methods: In a population-based case-control study of all adult deaths in Hong Kong Chinese in 1998, we used adjusted logistic regression to compare alcohol use in decedents aged ≥ 60 years from IHD (2270) and COPD (1441) with 10,320 living and 9043 dead controls (all non-alcohol related deaths). We also examined whether the association of alcohol use with death from IHD or COPD varied with sex or smoking status. Results: Using living controls and adjusted for age, socio-economic status and lifestyle, occasional and moderate alcohol use were generally associated with lower mortality from IHD and COPD. However, using dead controls the protection of occasional and moderate alcohol use appeared to be limited to ever-smokers for IHD (odds ratio (OR) 0.58, 95% confidence interval (CI) 0.46 to 0.73 for moderate compared to never-use in ever-smokers, but OR 1.07, 95% CI 0.76 to 1.50 in never-smokers), and possibly to men for COPD. High alcohol use was associated with lower IHD mortality and possibly with lower COPD mortality. Conclusion: High levels of alcohol use in an older Chinese population were associated with lower IHD mortality. Moderate alcohol use was less consistently protective against IHD mortality. Alcohol use was associated with lower COPD mortality particularly in men, either due to some yet to be clarified properties of alcohol or as the artefactual result of genetic selection into alcohol use in a Chinese population. Given the increasing use of alcohol in China with economic development, other designs and analytic strategies are needed to assess the impact of alcohol in this population, so that an evidence-based public health policy can be formulated.
Persistent Identifierhttp://hdl.handle.net/10722/151670
ISSN
2015 Impact Factor: 2.209
2015 SCImago Journal Rankings: 1.372
ISI Accession Number ID
Funding AgencyGrant Number
Hong Kong Health Services Research Committee631012
Hong Kong Council on Smoking and Health
Funding Information:

We thank the Immigration Department of the Government of the Hong Kong Special Administrative Region for their help with data collection. Dr SY Ho had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The LIMOR study was supported by Hong Kong Health Services Research Committee (#631012) and Hong Kong Council on Smoking and Health.

References
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DC FieldValueLanguage
dc.contributor.authorSchooling, CMen_US
dc.contributor.authorLam, THen_US
dc.contributor.authorHo, SYen_US
dc.contributor.authorHe, Yen_US
dc.contributor.authorMak, KHen_US
dc.contributor.authorLeung, GMen_US
dc.date.accessioned2012-06-26T06:26:21Z-
dc.date.available2012-06-26T06:26:21Z-
dc.date.issued2009en_US
dc.identifier.citationBmc Public Health, 2009, v. 9en_US
dc.identifier.issn1471-2458en_US
dc.identifier.urihttp://hdl.handle.net/10722/151670-
dc.description.abstractBackground: In observational studies moderate alcohol use reduces cardio-respiratory mortality. However observational studies may be biased by many factors including residual confounding by unmeasured differences between moderate alcohol users and other groups or by changes in alcohol use with ill-health and aging. We used two different analytic strategies in an under-studied population, i.e. southern Chinese, to provide an assessment of the specific impact of moderate alcohol use on mortality from ischemic heart disease (IHD) and chronic obstructive pulmonary diseases (COPD). Methods: In a population-based case-control study of all adult deaths in Hong Kong Chinese in 1998, we used adjusted logistic regression to compare alcohol use in decedents aged ≥ 60 years from IHD (2270) and COPD (1441) with 10,320 living and 9043 dead controls (all non-alcohol related deaths). We also examined whether the association of alcohol use with death from IHD or COPD varied with sex or smoking status. Results: Using living controls and adjusted for age, socio-economic status and lifestyle, occasional and moderate alcohol use were generally associated with lower mortality from IHD and COPD. However, using dead controls the protection of occasional and moderate alcohol use appeared to be limited to ever-smokers for IHD (odds ratio (OR) 0.58, 95% confidence interval (CI) 0.46 to 0.73 for moderate compared to never-use in ever-smokers, but OR 1.07, 95% CI 0.76 to 1.50 in never-smokers), and possibly to men for COPD. High alcohol use was associated with lower IHD mortality and possibly with lower COPD mortality. Conclusion: High levels of alcohol use in an older Chinese population were associated with lower IHD mortality. Moderate alcohol use was less consistently protective against IHD mortality. Alcohol use was associated with lower COPD mortality particularly in men, either due to some yet to be clarified properties of alcohol or as the artefactual result of genetic selection into alcohol use in a Chinese population. Given the increasing use of alcohol in China with economic development, other designs and analytic strategies are needed to assess the impact of alcohol in this population, so that an evidence-based public health policy can be formulated.en_US
dc.languageengen_US
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcpublichealth/en_US
dc.relation.ispartofBMC Public Healthen_US
dc.subject.meshAge Distributionen_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshAlcoholism - Diagnosis - Epidemiologyen_US
dc.subject.meshCase-Control Studiesen_US
dc.subject.meshCause Of Death - Trendsen_US
dc.subject.meshConfidence Intervalsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshLogistic Modelsen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMultivariate Analysisen_US
dc.subject.meshMyocardial Ischemia - Epidemiology - Mortalityen_US
dc.subject.meshOdds Ratioen_US
dc.subject.meshPopulation Surveillanceen_US
dc.subject.meshPrognosisen_US
dc.subject.meshPulmonary Disease, Chronic Obstructive - Epidemiology - Mortalityen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSeverity Of Illness Indexen_US
dc.subject.meshSex Distributionen_US
dc.subject.meshSurvival Analysisen_US
dc.subject.meshUrban Healthen_US
dc.titleAlcohol and cardio-respiratory deaths in Chinese: A population-based case-control study of 32,462 older Hong Kong adultsen_US
dc.typeArticleen_US
dc.identifier.emailSchooling, CM:cms1@hkucc.hku.hken_US
dc.identifier.emailLam, TH:hrmrlth@hkucc.hku.hken_US
dc.identifier.emailHo, SY:syho@hku.hken_US
dc.identifier.emailLeung, GM:gmleung@hku.hken_US
dc.identifier.authoritySchooling, CM=rp00504en_US
dc.identifier.authorityLam, TH=rp00326en_US
dc.identifier.authorityHo, SY=rp00427en_US
dc.identifier.authorityLeung, GM=rp00460en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1186/1471-2458-9-49en_US
dc.identifier.pmid19193244en_US
dc.identifier.scopuseid_2-s2.0-61649125215en_US
dc.identifier.hkuros154420-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-61649125215&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume9en_US
dc.identifier.isiWOS:000264289300001-
dc.publisher.placeUnited Kingdomen_US
dc.relation.projectA mega-case-control study (20,000 deaths and 30,000 controls) on smoking and mortality in Hong Kong-
dc.identifier.scopusauthoridSchooling, CM=12808565000en_US
dc.identifier.scopusauthoridLam, TH=7202522876en_US
dc.identifier.scopusauthoridHo, SY=7403716884en_US
dc.identifier.scopusauthoridHe, Y=7404942229en_US
dc.identifier.scopusauthoridMak, KH=8623141300en_US
dc.identifier.scopusauthoridLeung, GM=7007159841en_US
dc.identifier.citeulike4013015-

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