Article Text

Download PDFPDF
Alcohol consumption and all-cause mortality: an analysis of general practice database records for patients with long-term conditions
  1. Duncan Stewart,
  2. Lu Han,
  3. Tim Doran,
  4. Jim McCambridge
  1. Department of Health Sciences, University of York, Heslington, UK
  1. Correspondence to Duncan Stewart, Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK; duncan.stewart{at}


Background Alcohol is a risk factor for ill health and reduced life expectancy, but little is known about the impact of alcohol on mortality for people with existing long-term conditions. We used primary care data from the Clinical Practice Research Datalink (CPRD) to study relationships between alcohol consumption and all-cause mortality among general practice patients with long-term conditions.

Methods Data were accessed from a sample of 125 general practices from the CPRD database. Adult patients with long-term health conditions, a record of alcohol consumption in CPRD and at least 1 year of follow-up data between 2000 and 2014 (n=95 991) were matched to the Office for National Statistics (ONS) mortality register.

Results In Cox proportional hazards regression models, mortality was higher for patients consuming 25–34 units of alcohol per week (HR 1.26, 95% CI 1.12 to 1.42) and 35 units or more (HR 1.71, 95% CI 1.51 to 1.94), compared with those drinking 1–7 units per week. Patterns of mortality risk were the same for men and women. Heavy drinking increased mortality risk in combination with smoking (HR 4.04, 95% CI 3.41 to 4.79) and high levels of deprivation (HR 3.01, 95% CI 2.40 to 3.79).

Conclusions Heavier drinkers with long-term conditions are at significantly greater risk of death than lighter drinkers. The findings support the UK Chief Medical Officers’ guidance on having similar low-risk alcohol consumption guidelines for men and women. More needs to be done to tackle alcohol consumption among patients with long-term conditions.

  • Alcohol
  • mortality
  • general practice
  • smoking
  • deprivation

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors DS and JM designed the study, with technical input from TD and LH. DS extracted the data from CPRD and conducted the statistical analysis, with advice from LH. All authors contributed to data interpretation. DS and JM led the writing of the paper with critical review and approval of the final version from all authors.

  • Competing interests None declared.

  • Patient consent Data for this study are from an anonymised general practice database.

  • Provenance and peer review Not commissioned; externally peer reviewed.