Alcohol and coronary heart disease
Alcohol and coronary heart disease
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DOI：
10.1093/ije/30.4.724
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发表时间：
2001-08-01
影响因子：
7.7
通讯作者：
Marmot, MG
中科院分区：
文献类型：
--
作者：
Marmot, MG
回顾了两个问题的数据：大量饮酒是否会增加冠心病（CHD）的风险？而且，适量摄入有保护作用吗？已确定的酗酒者和有问题的饮酒者患冠心病的风险增加，在英国的 22 个城镇中，城镇中重度饮酒者的比例与冠心病死亡率之间存在相关性。在回顾的七项纵向研究中，其中一项显示酗酒者的冠心病发病率较高。在国际比较和美国的时间趋势中可以看出，饮酒量与冠心病死亡率之间呈负相关。在英国和美国审查的六项病例对照研究中，所有研究都显示冠心病与饮酒之间存在负相关性，在控制其他危险因素后这种相关性仍然存在。对日裔美国人、美国白人男性和女性、英国公务员、波多黎各人、南斯拉夫人和澳大利亚人进行的纵向研究都表明，适度饮酒者的冠心病风险低于戒酒者。戒酒者可能在很多方面与适度饮酒者有所不同。迄今为止，尚无法证明这些差异是戒酒者较高的冠心病风险的原因。明显的保护作用并不大（RR = 0.5），但关联的一致性和合理机制的存在增加了负关联是因果关系的可能性。然而，如果人口中的酒精摄入量增加，社会和医疗后果将是巨大的。因此，不建议将增加摄入量作为预防冠心病的社区措施。
The data on two questions are reviewed: does heavy alcohol intake increase the risk of coronary heart disease (CHD)? And, is moderate intake protective? Identified alcoholics and problem drinkers have an increased risk of CHD, and in Britain there is a correlation among 22 towns, between the proportion of heavy drinkers in a town and CHD mortality. Of seven longitudinal studies reviewed, one shows heavy drinkers to have an increased CHD incidence. An inverse association between alcohol consumption and CHD mortality is seen in international comparisons and in time trends in the USA. Of six case-control studies reviewed from England and the USA, all show an inverse association between CHD and alcohol consumption which persists after control for other risk factors. Longitudinal studies, in Japanese-Americans, white American men and women, British civil servants, Puerto Ricans, Yugoslavs and Australians, all show moderate drinkers to have a lower CHD risk than abstainers. Abstainers are likely to differ from moderate drinkers in a number of ways. To date it has not proved possible to show that any of these differences account for the higher CHD risk of abstainers. The apparent protective effect is not large (RR=0.5) but the consistency of the association and the existence of plausible mechanisms increase the likelihood that the negative association is causal. However, if alcohol intake were to increase in the population the social and medical consequences would be large. An increased intake is therefore not recommended as a community measure for CHD prevention.