Research in contextEvidence before this studyWe searched for prospective epidemiological studies of alcohol consumption investigating disease risk thresholds published in any language up until March 1, 2017 (with no specified earliest date), in PubMed, Scientific Citation Index Expanded, and Embase using relevant terms (“alcohol”, “mortality”, “survival”, “cardiovascular disease”, “cohort”, and “prospective”). We found many primary reports and literature-based reviews. However, no study had combined the following key features required to achieve reliable estimates of dose–response associations: availability of individual-participant data; quantitative assessment of alcohol consumption levels using validated instruments; periodic re-surveys of alcohol consumption levels; recording of large numbers of deaths (eg, >20 000 deaths); and sufficient detail and power to disaggregate incident cardiovascular disease outcomes into subtypes (eg, >20 000 incident total cardiovascular disease outcomes).Added value of this studyThe current study combined all the key study design features mentioned above, and afforded several additional advantages. First, it reduced the potentially distorting effects of reverse causality by focusing on current drinkers without previous cardiovascular disease who survived at least 12 months of follow-up. Second, it enhanced generalisability by including individual-participant
