Alcohol consumption and risk for coronary heart disease in men with healthy lifestyles
Alcohol consumption and risk for coronary heart disease in men with healthy lifestyles
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DOI：
10.1001/archinte.166.19.2145
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发表时间：
2006-10-23
影响因子：
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通讯作者：
Rimm, Eric B.
中科院分区：
文献类型：
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作者：
Mukamal, Kenneth J.;Chiuve, Stephanie E.;Rimm, Eric B.
背景：虽然适度饮酒与心肌梗死（MI）风险降低相关，但指南通常建议成年人寻求其他生活方式措施来降低心血管风险。我们研究了在一直报告良好生活方式的男性中，饮酒是否与冠心病风险呈负相关。方法：从51 529名健康专业人员随访研究的男性参与者中，我们定义了8867名无重大疾病的男性参与一项前瞻性研究，这些参与者自1986年以来在两年一次的问卷调查中报告了饮食和其他生活方式因素。所有参与者报告了4种健康的生活方式行为，包括身体质量指数（以体重公斤除以身高米的平方计算）小于25，每天中等到剧烈运动30分钟或更长时间，戒烟，以及男性的综合饮食得分在前50%。饮食得分高反映了大量摄入蔬菜、水果、谷物纤维、鱼、鸡、坚果、大豆和多不饱和脂肪；少吃反式脂肪、红肉和加工肉；还有多种维生素的使用。我们根据每4年报告的啤酒、葡萄酒和白酒的摄入量来确定非致死性心肌梗死和致死性冠心病的发生率。结果：在16年的随访中，我们记录了106例心肌梗死事件。与不饮酒相比，酒精摄入量为0.1至4.9 g/d的心肌梗死风险比为0.98(95%可信区间，0.55-1.74)，酒精摄入量为5.0至14.9 g/d的心肌梗死风险比为0.59(95%可信区间，0.33-1.07)，酒精摄入量为15.0至29.9 g/d的心肌梗死风险比为0.38(95%可信区间，0.16-0.89)，酒精摄入量为30.0 g/d或以上的心肌梗死风险比为0.86（95%可信区间，0.36-2.05）。在符合3项标准的男性中，酒精摄入量为5.0至29.9克/天的风险较低，与保持健康生活方式行为的风险较低相似。结论：即使在基于身体质量指数、体力活动、吸烟和饮食已经处于低风险的男性中，适量饮酒也与心肌梗死的低风险相关。
Background: Although moderate alcohol intake is associated with lower risk for myocardial infarction (MI), guidelines generally suggest that adults seek other lifestyle measures to reduce cardiovascular risk. We studied whether alcohol consumption is inversely associated with risk for coronary heart disease in men who report consistently favorable lifestyle behaviors.Methods: From 51 529 male participants of the Health Professionals Follow-up Study who have reported diet and other lifestyle factors in biennial questionnaires since 1986, we defined a cohort of 8867 men free of major illness to participate in a prospective study. All participants reported 4 healthy lifestyle behaviors, including a body mass index (calculated as weight in kilograms divided by height in meters squared) of less than 25, moderate to vigorous activity for 30 minutes or more per day, abstention from smoking, and a summary diet score in the top 50% for men. High dietary scores reflected a high intake of vegetables, fruits, cereal fiber, fish, chicken, nuts, soy, and polyunsaturated fat; low consumption of trans-fat, and red and processed meats; and multivitamin use. We ascertained the incidence of nonfatal MI and fatal coronary heart disease according to reported intake of beer, wine, and liquor every 4 years.Results: During 16 years of follow-up, we documented 106 incident cases of MI. Compared with abstention, the hazard ratios for MI were 0.98 (95% confidence interval, 0.55-1.74) for alcohol intake of 0.1 to 4.9 g/d, 0.59 (95% confidence interval, 0.33-1.07) for alcohol intake of 5.0 to 14.9 g/d, 0.38 (95% confidence interval, 0.16-0.89) for alcohol intake of 15.0 to 29.9 g/d, and 0.86 (95% confidence interval, 0.36-2.05) for alcohol intake of 30.0 g/d or more. In men who met 3 criteria, the lower risk associated with alcohol intake of 5.0 to 29.9 g/d tended to be similar to the lower risk associated with the remaining healthy lifestyle behavior.Conclusion: Even in men already at low risk on the basis of body mass index, physical activity, smoking, and diet, moderate alcohol intake is associated with lower risk for MI.