Association of Binge Drinking and Resting Heart Rate with All-Cause and Cardiovascular Diseases Mortality in Older Men: The Kangwha Cohort Study
OBJECTIVE: The combined effect of binge drinking and resting heart rate on mortality has rarely been assessed. In this study, the combined effect of binge drinking and resting heart rate on all-cause and cardiovascular mortality in older Korean men has been assessed. Furthermore, the potential modifying effect of resting heart rate on this association has been evaluated. Subjects & METHODS: Older men aged 55 years of older (n=2,600) were followed for cardiovascular and all-cause mortality for 20.8 years from March 1985 to December 31, 2005. We estimated hazard ratios (HR) for cardiovascular and all-cause mortality by binge drinking and resting heart rate using the Cox proportional hazard model after adjusting confounding factors. Binge drinkers and heavy binge drinkers were defined as having ≥6 drinks on 1 occasion and ≥12 drinks on 1 occasion. RESULTS: There were 1,990 (76.5%) deaths during the 20.8 years of follow-up. After adjusting for confounding factors, compared to non-drinkers, heavy binge drinkers had 1.9-fold increased risk of cardiovascular mortality (HR=1.92; 95% CI: 1.13~3.27), and 1.4-fold increased risk of total mortality (HR=1.43; 95% CI: 1.11~1.81). In addition, subjects with ≤60 bpm resting heart rate had 1.07-fold increased risk of cardiovascular mortality (HR=1.07; 95% CI: 0.89~1.29), and 1.08-fold increased risk of all-cause mortality (HR=1.08; 95% CI: 0.93~1.26) compared to resting heart rate with 61-79 bpm. Resting heart rate with ≥80 bpm had increased risk of cardiovascular mortality (HR=1.32; 95% CI: 1.18~1.49), and all-cause mortality (HR=1.13; 95% CI: 1.02~1.26). Combined effect of binge drinking and resting heart rate shows that after adjusting for confounding factors, heavy binge drinkers (≥12 drinks on one occasion) with resting heart rate ≤60 bpm had 5-fold increased risk of cardiovascular mortality (HR=4.99; 95% CI: 1.24~20.18) and 4-fold risk of all-cause mortality (HR=4.13; 95% CI: 1.32~12.89) compared to the reference group (non-drinking and resting heart rate 61-79 beats per minute (bpm)). Also, heavy binge drinkers (≥12 drinks on one occasion) with elevated resting heart rate (≥80bpm) had higher risk of death from cardiovascular disease (HR=2.26; 95% CI: 1.48~ 2.46) and all-cause mortality (HR=1.37; 95% CI: 0.87~2.14). CONCLUSION: Our findings suggest that heavy binge drinking (≥12 drinks per occasion) with higher (≥80bpm) or lower (≤60 bpm) resting heart rate than 61-79 bpm are at higher risk for cardiovascular and all-cause mortality in older Korean men. These findings suggest that old men with resting heart rate ≤60 bpm or ≥80 bpm, should avoid drinking more than 12 glasses in an occasion in order to prevent total and cardiovascular death.
binge drinking, cardiovascular disease, mortality, resting heart rate
Networked Digital Library of Theses and Dissertations