Information on alcohol consumption was collected and included weekly drinking frequency (times per week) and daily consumption (standard drinks per day). One standard drink was defined as 10 g of alcohol. Alcohol-related classification followed the standards of the World Health Organization (WHO) [9]. A working definition from the WHO standards describes hazardous drinking as a regular, average alcohol consumption of ≥40 g/day for males and ≥ 20 g/day for females. Therefore, high alcohol consumption for male and female participants in this study was designated as ≥40 g/day and ≥ 20 g/day, respectively. CVD was the primary outcome and was defined as ≥2 days of hospitalization due to IHD or stroke. Before admission, the attending physician recorded a primary diagnosis according to the ICD-10 codes. The ICD-10 codes for CVD (I20–I25 and I60–I69), IHD (I20–I25), stroke (I60–I69), ischemic stroke (I63), and hemorrhagic stroke (I61–I62) were derived from the guidelines of the American Heart Association [10].

A self-reported questionnaire was used to obtain data on household income; history of dyslipidemia, hypertension, and diabetes mellitus; smoking status; alcohol consumption (as defined above); and physical activity. Physiological and serological measurements were collected at a health examination performed within 2 years prior to the 5-year survival date and included body mass index, waist circumference, blood pressure, fasting serum glucose, total cholesterol, and liver function tests. The Charlson Comorbidity Index (CCI) was calculated in accordance with a previous study [11]. Before hospital admission for a CVD event, the attending physician recorded a primary diagnosis using the ICD-10 codes for CVD as described above.

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