Association of alcohol consumption with aortic aneurysm and dissection risk: results from the UK Biobank cohort study

doi:10.5847/wjem.j.1920-8642.2024.096

Abstract

Abstract:

BACKGROUND: Previous studies have reported inconsistent results with positive, negative, and J-shaped associations between alcohol consumption and the hazard of aortic aneurysm and dissection (AAD). This study aimed to examine the connections between weekly alcohol consumption and the subsequent risk of AAD.

METHODS: The UK Biobank study is a population-based cohort study. Weekly alcohol consumption was assessed using self-reported questionnaires and the congenital risk of alcohol consumption was also evaluated using genetic risk score (GRS). Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the associations between alcohol consumption and AAD. Several sensitivity analyses were performed to assess the robustness of the results.

RESULTS: Among the 388,955 participants (mean age: 57.1 years, 47.4% male), 2,895 incident AAD cases were documented during a median follow-up of 12.5 years. Compared with never-drinkers, moderate drinkers (adjusted HR: 0.797, 95%CI: 0.646-0.984, P<0.05) and moderate-heavy drinkers (adjusted HR: 0.794, 95%CI: 0.635-0.992, P<0.05) were significantly associated with a decreased risk of incident AAD. Interaction-based subgroup analysis revealed that the protective effect of moderate drinking was reflected mainly in participants younger than 65 years and women.

CONCLUSION: Our findings support a protective effect of moderate alcohol consumption on AAD, but are limited to participants younger than 65 years and women.

Key words: Alcohol consumption, Aortic aneurysm and dissection, Genetic risk score, Cohort study, UK Biobank

Yaowen Liang, Guoxiang Zou, Dingchen Wang, Weiyue Zeng, Jiarui Zhang, Xiaoran Huang, Miao Lin, Cong Mai, Fei'er Song, Yuelin Zhang, Jinxiu Meng, Hongliang Feng, Yu Huang, Xin Li. Association of alcohol consumption with aortic aneurysm and dissection risk: results from the UK Biobank cohort study[J]. World Journal of Emergency Medicine, 2024, 15(6): 465-474.

Figures/Tables 7

Figure 1.

Table 1.

Baseline characteristics stratified by alcohol consumption

Characteristics	Overall (n=388,955)	Never-drinkers (n=19,999)	Former-drinkers (n=16,717)	Mild drinkers (n=157,188)	Moderate drinkers (n=106,554)	Moderate-heavy drinkers (n=47,627)	Heavy drinkers (n=40,870)	P-value
Age, years < 65 years ≥ 65 years	57.1 ± 8.1 81.0 19.0	57.0 ± 8.6 75.8 24.2	57.18 ± 7.9 79.1 20.9	56.5 ± 8.1 80.8 19.2	56.5 ± 8.0 81.5 18.5	56.5 ± 7.9 82.3 17.7	56.5 ± 7.8 82.5 17.5	<0.001
Sex, % Female Male	52.6 47.4	72.1 27.9	55.7 44.3	63.7 36.3	48.4 51.6	36.5 63.5	25.7 74.3	<0.001
Ethnicity, % Not white White	5.2 94.8	29.5 70.5	8.1 91.9	5.3 94.7	2.5 97.5	2.0 98.0	1.8 98.2	<0.001
Townsend deprivation index	-1.4 ± 3.0	-0.3 ± 3.4	-0.1 ± 3.5	-1.5 ± 2.9	-1.7 ± 2.9	-1.6 ± 2.9	-1.3 ± 3.0	<0.001
Education level, % No qualification Any other qualification College degree or above	15.8 49.8 34.4	26.9 46.5 26.6	26.9 46.9 26.2	15.8 50.8 33.4	13.9 49.3 36.8	13.0 49.6 37.4	14.2 50.6 35.1	<0.001
Smoking status, % Never smokers Former/current smokers	54.4 45.6	81.9 18.1	44.6 55.4	62.1 37.9	51.5 48.5	42.0 58.0	34.3 65.7	<0.001
Regular physical activity, % No Yes	33.3 66.7	44.6 55.4	30.6 69.4	33.8 66.2	30.8 69.2	30.1 69.9	31.8 68.2	<0.001
Systolic blood pressure, mmHg	139.8 ± 19.6	139.2 ± 20.4	137.7 ± 19.9	138.5 ± 19.7	139.8 ± 19.3	141.9 ± 19.1	144.6 ± 19.2	<0.001
Diastolic blood pressure, mmHg	82.2 ± 10.6	81.3 ± 10.8	80.7 ± 10.8	81.3 ± 10.6	82.3 ± 10.5	83.7 ± 10.6	85.4 ± 10.5	<0.001
Body mass index, kg/m² < 25 kg/m², % ≥ 25 to <30 kg/m², % ≥ 30 kg/m², %	27.2 ± 4.6 34.1 43.2 22.7	28.1 ± 5.6 31.1 38.3 30.6	28.2 ± 5.7 30.6 37.9 31.5	27.1 ± 4.7 36.6 41.0 22.4	26.9 ± 4.3 35.5 44.6 19.9	27.2 ± 4.2 31.2 47.0 21.8	27.7 ± 4.2 26.2 48.8 25.0	<0.001
Cholesterol-lowering medication use, % No Yes	90.1 9.9	87.5 12.5	88.4 11.6	90.3 9.7	90.9 9.1	90.3 9.7	89.2 10.8	<0.001
Baseline CVD, % No Yes	94.5 5.5	92.3 7.7	89.3 10.7	95.2 4.8	94.9 5.1	94.6 5.4	94.0 6.0	<0.001
Baseline diabetes, % No Yes	95.2 4.8	89.8 10.2	89.4 10.6	95.4 4.6	96.2 3.8	96.1 3.9	95.6 4.4	<0.001

Table 1.

Table 2.

Figure 2.

Figure 3.

Table 3.

Figure 4.

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Alcohol consumption	AAD events/N	Person-year	Model 1 HR (95%CI)	Model 2 HR (95%CI)
Never-drinkers	106/19,999	246,484	ref	ref
Former-drinkers	178/16,717	201,296	1.257 (0.986-1.603)	1.155 (0.904-1.475)
Mild drinkers	981/157,188	1,932,136	0.904 (0.739-1.106)	0.922 (0.751-1.132)
Moderate drinkers	764/106,554	1,328,554	0.777 (0.632-0.954)*	0.797 (0.646-0.984)*
Moderate-heavy drinkers	405/47,627	592,064	0.773 (0.621-0.961)*	0.794 (0.635-0.992)*
Heavy drinkers	461/40,870	503,742	0.886 (0.713-1.100)	0.891 (0.713-1.112)
P for trend			0.018	0.041

GRS of alcohol consumption	AAD events/N	Person-year	Model 2 HR (95%CI)
Low GRS	996/129,538	1,597,650	ref
Intermediate GRS	911/129,925	1,604,955	0.883 (0.807-0.966)**
High GRS	988/129,492	1,620,818	0.952 (0.871-1.040)
P for trend			0.281