Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis.
Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis.
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DOI：
10.1136/bmj.d671
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发表时间：
2011-02-22
期刊：
影响因子：
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通讯作者：
Ghali WA
中科院分区：
文献类型：
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作者：
Ronksley PE;Brien SE;Turner BJ;Mukamal KJ;Ghali WA
目的对饮酒对多种心血管结局影响的研究进行系统评价和荟萃分析。设计系统综述和荟萃分析。数据来源：检索Medline（1950年至2009年9月）和Embase（1980年至2009年9月），辅以文献和会议记录的手动检索。纳入标准：饮酒与心血管疾病总死亡率、冠心病发病率和死亡率、卒中发病率和死亡率之间关系的前瞻性队列研究。 在对4235项研究的合格性、质量和数据提取进行审查的研究中，84项被纳入最终分析。结果在随机效应模型中，饮酒者相对于不饮酒者的合并校正相对危险度为0.75心血管疾病死亡率（95%置信区间0.70 - 0.80）（21项研究），0.71（0.66至0.77）对于冠心病事件（29项研究），0.75（0.68至0.81）的冠心病死亡率（31项研究），0.98（0.91至1.06）的中风事件（17项研究），和1.06（0.91至1.23）的中风死亡率（10项研究）。剂量反应分析显示，每天饮酒1-2次的冠心病死亡率风险最低，但对于中风死亡率，每天饮酒≤1次的风险最低。对所有原因死亡率的二次分析显示，饮酒者的风险低于不饮酒者（相对风险为0.87（0.83至0.92））。结论：轻度至中度饮酒与多种心血管结局风险降低相关。
Objective To conduct a comprehensive systematic review and meta-analysis of studies assessing the effect of alcohol consumption on multiple cardiovascular outcomes. Design Systematic review and meta-analysis. Data sources A search of Medline (1950 through September 2009) and Embase (1980 through September 2009) supplemented by manual searches of bibliographies and conference proceedings. Inclusion criteria Prospective cohort studies on the association between alcohol consumption and overall mortality from cardiovascular disease, incidence of and mortality from coronary heart disease, and incidence of and mortality from stroke. Studies reviewed Of 4235 studies reviewed for eligibility, quality, and data extraction, 84 were included in the final analysis. Results The pooled adjusted relative risks for alcohol drinkers relative to non-drinkers in random effects models for the outcomes of interest were 0.75 (95% confidence interval 0.70 to 0.80) for cardiovascular disease mortality (21 studies), 0.71 (0.66 to 0.77) for incident coronary heart disease (29 studies), 0.75 (0.68 to 0.81) for coronary heart disease mortality (31 studies), 0.98 (0.91 to 1.06) for incident stroke (17 studies), and 1.06 (0.91 to 1.23) for stroke mortality (10 studies). Dose-response analysis revealed that the lowest risk of coronary heart disease mortality occurred with 1–2 drinks a day, but for stroke mortality it occurred with ≤1 drink per day. Secondary analysis of mortality from all causes showed lower risk for drinkers compared with non-drinkers (relative risk 0.87 (0.83 to 0.92)). Conclusions Light to moderate alcohol consumption is associated with a reduced risk of multiple cardiovascular outcomes.