(P26-26-26) Association of Self-Reported Alcohol Consumption With Major Adverse Cardiovascular Event, Cancer, and Mortality Among United States Veterans: VA Million Veteran Program

Sunday, July 26, 2026

9:30 AM - 10:30 AM ET

Location: Poster Board C-72

Presenting Author(s)

YL

Yanping Li, PhD (she/her/hers)

Health Science Specialist
Boston Cooperative Studies Program Epidemiology Center, VA Boston Healthcare System
Boston, Massachusetts, United States

Co-Author(s)

XN

Xuan-Mai T. Nguyen, MD, PhD

Resident Physician
University of California, Los Angeles
Fountain Valley, California, United States
SH

Serena Houghton

VA Boston Healthcare System
YH

Yuk-Lam Ho, MPH

US Department of Veterans Affairs
Jamaica Plain, Massachusetts, United States
BC

Brian R. Charest

Massachusetts Veterans Epidemiology Research and Information Collaborative, VA Boston Healthcare System, United States
DW

Dong D. Wang, ScD

Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School
Boston, Massachusetts, United States
DG

David R. Gagnon

Boston University School of Public Health, United States
YZ

Yu Zhang, MBBS (he/him/his)

Graduate Student
Harvard T.H. Chan School of Public Health
Boston, Massachusetts, United States
JG

J. Michael Gaziano

VA Boston Healthcare System
WW

Walter C. Willett, DrPH, MPH, MD

Professor
Harvard T.H. Chan School of Public Health
Boston, Massachusetts, United States
Frank B. Hu, MD, MPH, PhD (he/him/his)

Chair, Department of Nutrition; Fredrick J. Stare Professor of Nutrition and Epidemiology
Harvard T.H. Chan School of Public Health
Boston, Massachusetts, United States
KC

Kelly Cho, PhD, MPH

VA Boston Healthcare System
Jamaica Plain, Massachusetts, United States
PW

Peter W. Wilson

Emory University Rollins School of Public Health, United States

Disclosure(s):

Yanping Li, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: To examine the associations of alcohol consumption and major adverse cardiovascular events (MACE- myocardial infarction, stroke, or cardiovascular death), cancers, and total mortality.

Methods: Self-reported alcohol consumption was collected from 438,442 MVP participants from the prospective study of Million Veteran Program (MVP 2011-2024). The outcomes included total mortality, cancer incidents and MACE.

Results: Compared to veterans who never consumed alcohol, the hazard ratio (HR) for mortality was 1.08 (95%CI: 1.05-1.11) among former drinkers and for current drinkers was 0.86 (0.84-0.89) [0.1-30g/d], 0.88 (0.84-0.91) [31-60g/d], 1.04 (1.00-1.09) [61-90g/d] and 1.19 (1.08-1.31) [ >90g/d] (both P for curvature and P for linear trend < 0.0001). The HRs for MACE incidence was 1.01 (0.96-1.06) for former drinkers and J-shaped for current drinking: 0.84 (0.80-0.89) [0.1-30g/d], 0.79 (0.73-0.85) [31-60g/d], 0.93 (0.84-1.03) [61-90g/d] and 1.13 (0.95-1.36) [ >90g/d] (P for curvature < 0.0001, P for linear trend = 0.24). The HR for alcohol-related cancers was 1.33 (95%CI: 1.19-1.48) for former drinkers and positively associated with the amount of current drinking: 1.06 (0.96-1.18) [0.1-30g/d], 1.19 (1.03-1.37) [31-60g/d], 1.73 (1.47-2.03) [61-90g/d] and 1.49 (1.08-2.05) [ >90g/d] (P for curvature =0.26, P for linear trend < 0.0001). Compared to participants who reported never smoking and never drinking alcohol, HR for head and neck cancers was 3.21 (2.17-4.74) among current smokers with moderate alcohol consumption (female up to 1 and male up to 2 drinks per day) and 5.69 (3.76-8.62) among current smokers with heavy drinking (P for interaction=0.03).

Conclusions: Among US veterans, alcohol consumption was associated with mortality and MACE in a J-shaped pattern, with the lowest risk observed at moderate consumption levels. Conversely, alcohol consumption demonstrates a linear increasing risk for cancers, with increased risks for alcohol-related cancers even at moderate consumption levels. The risk of head and neck cancer associated with alcohol consumption was significantly exacerbated by smoking.

Funding Sources: VA MVP#000 and MVP#001, and VA award # BX004821