Alcohol and mortality: the Honolulu Heart Study.

It has been shown previously that coronary heart disease was less likely to develop in Japanese men in Honolulu who drank alcoholic beverages than in those who abstained, and that the more they drank (up to about 60 ml/day of ethanol) the lower the risk. In this report on the same men, it is shown that the same sort of relation holds for mortality from coronary heart disease but that the reverse is true for death from cancer and from stroke. Men who drank were more likely to die from these causes than those who abstained, and the more they drank the greater the risk of death. Men who drank relatively large amounts were more likely to die from cirrhosis of the liver than other men. The resultant curve for total mortality is u-shaped, the lowest risk being for men who consumed from 1 to 10 ml/day of ethanol. Even at that low level of consumption, however, the risk of death from cancer or stroke was greater than it was for nondrinkers. In short, for this population of Japanese men, alcohol consumption appears to have some benefits and some hazards with regard to mortality, and the benefit or hazard depends on which cause of death is being considered.