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In light of current debates on the U or J shaped relation observed between consumption and aggregated cardiovascular disease outcomes we defined five categories of drinking: non-drinkers (Read codes such as “teetotaller” and “non-drinker”), former drinkers (those with codes for “stopped drinking alcohol” and/or “ex-drinker”), occasional drinkers (those with codes for “drinks rarely” and/or “drinks occasionally”), current moderate drinkers (codes such as “alcohol intake within recommended sensible limits” and “light drinker”), and heavy drinkers (codes including “alcohol intake above recommended sensible drinking limits” and “hazardous alcohol use”).We also used data fields with information entered on daily and/or weekly amount of alcohol consumed to define participants as non-drinkers, moderate drinkers (drank within daily and/or weekly recommended sensible drinking limits for the UK at the time of observation37), and heavy drinkers (exceeded daily and/or weekly sensible drinking limits).We additionally estimated associations with non-cardiovascular disease mortality as well as coronary heart disease and stroke events that were not otherwise specified.For comparisons with existing studies we estimated models for aggregated coronary heart disease (myocardial infarction and unheralded death from coronary heart disease), cardiovascular disease (all cardiovascular endpoints other than stable angina), fatal cardiovascular disease (combination of fatal coronary heart disease and fatal cardiovascular disease), and all cause mortality.Our Word of the Year choice serves as a symbol of each year’s most meaningful events and lookup trends.

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We included 1 937 360 anonymised patients from the CALIBER (CArdiovascular research using LInked Bespoke studies and Electronic health Records) programme.29 Details of the enrolment, follow-up, and data sources are presented in the appendix.Conclusions Heterogeneous associations exist between level of alcohol consumption and the initial presentation of cardiovascular diseases.This has implications for counselling patients, public health communication, and clinical research, suggesting a more nuanced approach to the role of alcohol in prevention of cardiovascular disease is necessary.CPRD provides primary care data on health behaviours, diagnoses, investigations, procedures, and prescriptions; and its accuracy and completeness are regularly audited.CPRD patients are representative of the UK population in terms of age, sex, ethnicity,3031 and overall mortality32 and have been validated for epidemiological research.33 Patient CPRD data were further linked with three other data sources: the Myocardial Ischaemia National Audit Project registry (MINAP)34; hospital episodes statistics (HES); and the Office for National Statistics (ONS).

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