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Majken K. Jensen

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Review Open access Aug 2026

Identifying drinking patterns in a middle-aged population and their association with coronary heart disease, stroke, and all-cause mortality risk: the Danish Health Examination Survey

Abstract Alcohol drinking patterns encompass various dimensions of consumption. However, most studies have focused narrowly on the quantity of alcohol consumed. This study aimed to identify alcohol-drinking patterns in middle-aged population using alcohol-related variables and to examine their relationship with coronary heart disease (CHD), stroke, and all-cause-mortality risk. The present population-based study included adults from the Danish Health Examination Survey (DANHES) cohort who were ≥40 years old and free of CHD and stroke at baseline (n = 46 141). Latent Class Analysis (LCA) was used to identify distinct subpopulations based on six alcohol-related variables (amount, frequency, binge episodes, type, within meals, at home and alone). Cox proportional hazard models were used to estimate hazard ratios (95% confidence interval) between drinking patterns and CHD, stroke, and all-cause mortality during a median follow-up of 11.8 years. Four classes of drinking patterns were identified in both sexes (labeled as “low drinkers,” “low-to-moderate drinkers,” “moderate-regular drinkers,” and “frequent-heavy drinkers”). The more frequent drinking pattern was a median of 3 (2–5) drinks per week. Frequent heavy drinking was associated with a higher risk of stroke. Individuals in the low-to-moderate male drinking class and the moderate-regular female drinking class not under heart medication had a lower risk of all-cause mortality than low-level drinkers. Four distinct drinking patterns were identified. Among individuals 40 years and older, frequent-heavy drinking was associated with a higher risk of stroke, while low-to-moderate regular drinking might be associated with a lower all-cause mortality risk compared to low drinkers.

Marta Trius-Soler, M. Guasch-Ferré, Cristina Valle-Hita et al. · 0 citations
Open access Jul 2026

Long-term adherence to glucose-lowering therapy and cardiovascular risk in type 2 diabetes: a nationwide cohort study

Summary Background Type 2 diabetes is a major risk factor for cardiovascular disease, and reducing this excess risk is a central goal of clinical management. Sustained adherence to glucose-lowering medication is considered a key component of this strategy. However, long-term patterns of medication-taking behavior in real-world settings, and their relationship with cardiovascular outcomes, remain insufficiently characterized. Methods We conducted a nationwide cohort study of Danish adults with newly diagnosed type 2 diabetes who initiated non-insulin glucose-lowering medication between 2005 and 2012. Medication adherence was estimated from pharmacy dispensing data, and group-based trajectory modeling was used to identify longitudinal adherence patterns. The primary outcome was a composite cardiovascular outcome including ischemic heart disease, stroke, or heart failure. Associations between adherence trajectories and cardiovascular outcomes over 10 years of follow-up were assessed with Cox proportional-hazards models. Findings Among 79,510 individuals with newly diagnosed type 2 diabetes (median age, 61 (IQR: 52–69); 57% men), we identified three long-term adherence trajectories defined by high (n = 32,912; 41%), intermediate (n = 25,822; 33%), and low (n = 20,776; 26%) adherence. During follow-up, 15,276 cardiovascular events occurred. Compared with the high-adherence group, adjusted hazard ratios for the composite cardiovascular outcome were 1.07 (95% CI, 1.03–1.12) and 1.27 (95% CI, 1.21–1.33) in the intermediate- and low-adherence groups, respectively. Participants with high adherence remained free of cardiovascular events for an average of 220 more days (95% CI, 204–237) over 10 years. Associations were largely driven by ischemic heart disease, with no significant associations for heart failure. Interpretation Long-term adherence to glucose-lowering medication was associated with lower cardiovascular rate and longer event-free survival time among individuals with newly diagnosed type 2 diabetes. Funding Novo Nordisk Foundation and the European Innovation Council.

Lise B. Nielsen, A. Bartholdy, Tri-Long Nguyen et al. · 0 citations

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