Relation between heavy and binge drinking and all-cause and cardiovascular mortality in Novosibirsk, Russia: a prospective cohort study

Background Moderate alcohol consumption is associated with reduced cardiovascular mortality, but binge drinking is thought to be detrimental. We examined effects of heavy and binge drinking in a population with high rates of binge drinking. Methods We did a prospective cohort study in Novosibirsk, Russia, in 6502 men aged 25–64 years at baseline who were examined in WHO MONICA (monitoring trends and determinants in cardiovascular disease surveys) in 1985/86, 1988/89, and 1994/95, and in a pilot study in 1984. We assessed alcohol intake and drinking pattern by questionnaire; binge drinking was defined as consumption of 160 g or greater of pure alcohol on a typical occasion. Participants were followed—up for a median of 9•5 years (range 3•1–15•2). Findings There were 836 deaths in the cohort, 395 of which resulted from cardiovascular diseases. Prevalence of binge drinking at baseline was 16% (n=1005). Adjusted relative risks for binge drinking at least once a month (compared with consumption of <80 g pure alcohol) were 1•05 (95% Cl 0•80–1•36) for deaths from all causes, 0•99 (0•66–1•50) for deaths from cardiovascular disease, 1•27 (0•81–1•99) for deaths from coronary heart disease, and 2•08 (1•08–3•99) for death from external causes. Risk of total and cardiovascular mortality was raised in a small group of frequent heavy drinkers (5% [264] of all drinkers); for this group, adjusted relative risks were 1•61 (1•04–2•50) for total mortality and 2•05 (1•09–3•86) for deaths from cardiovascular disease. Interpretation The risk of death from cardiovascular disease seems to be increased in frequent heavy drinkers, but is not necessarily associated with episodic binge drinking.