Alcohol Harms: The relationship between alcohol consumption and cardiovascular risk - A life-course perspective

重要的是要研究生活方式行为，如饮酒，与我们的健康有关。人们普遍认为适度饮酒对心脏有好处，但这真的是真的吗？大多数关于饮酒和心血管健康的科学研究只记录了人们在某个时间点的饮酒习惯，并假设它们不会改变。这种假设不太可能是真的。人们一生中都会改变他们喝酒的方式，并不是每个人都随着年龄的增长而遵循同样的饮酒模式。有些人在成为适度消费者之前可能会在生命早期大量饮酒，而另一些人可能会随着时间的推移增加酒精摄入量，当然，有些人可能根本不喝酒。那些不喝酒的人是一个特别重要的研究群体，因为许多研究的汇总结果表明，戒酒的人患心血管疾病的风险更高。但如前所述，这些研究是基于人们在那个时间点报告的饮酒情况;他们忽略了在那之前可能饮酒的整个历史。当人们身体不适时，他们可能会选择戒酒或大幅减少饮酒量。这意味着，被证明具有较高心血管疾病风险的非饮酒者群体实际上可能由从未饮酒的人组成，以及那些曾经饮酒但因健康状况不佳而戒烟的人。因此，我们可能会错误地认为饮酒对我们有益，因为健康的适度饮酒者与可能已经生病的非饮酒者相比。有些人可能会选择喝酒，相信这对他们有好处，但如果目前的证据是错误的，那么他们实际上可能会在不知不觉中将自己置于危险之中。同样重要的是，我们也要检查那些终生饮酒的人的饮酒史。可能是生活中有特定的时间点，饮酒危害更大。如果我们能够确定生命过程中的这些敏感时期，我们将能够更好地采取行动，以确保a）密切监测那些基于饮酒史的高风险人群（我们的研究结果可用于改进预测模型），以及B）制定策略，使人们意识到这一点，以便他们能够对自己的饮酒习惯做出明智的选择。拟议的项目将使用数千名不同年龄的人的现有数据，随着时间的推移，以探索这些确切的问题。在整个生命过程中饮酒与心血管疾病的发生有什么关系？有没有证据表明，适量饮酒对心脏有好处，当与一组健康的非饮酒者相比？在生活中，饮酒对我们的伤害最大的时候是什么时候？ 我们将使用创新的统计方法来考虑饮酒量变化与心血管疾病风险之间的复杂关系，并探索饮酒如何影响心血管疾病的生物标志物（如血压和胆固醇），以更好地了解饮酒增加或降低心血管疾病风险的途径。我们将记录最佳实践，以便其他人可以使用这些方法来探索终身饮酒与不同健康结果的关系。最终，希望这项工作的结果将有助于减少继续发展或死于心血管疾病的人数，提高我们对生命过程中预防策略可能最有用的特定时期的理解，并开发更复杂的评估高危人群的方法。

It is important to examine how lifestyle behaviours, such as drinking alcohol, are related to our health. It has been widely cited that moderate alcohol consumption is good for the heart - but is this really true? The majority of scientific studies on the topic of drinking and cardiovascular health have only recorded the drinking habits of people at one point in time and assumed that they do not change. This assumption is unlikely to be true. People change the way they drink throughout life and not everyone follows the same pattern of drinking as they age. Some people may drink heavily earlier in life before becoming moderate consumers, while others may increase their alcohol intake over time, and of course, some people may not drink alcohol at all.Those that do not drink alcohol are a particularly important group to study, as pooled findings from many studies show that those who abstain from alcohol have a higher risk of developing cardiovascular disease. But as mentioned previously, these studies are based on what people report drinking at that point in time; they ignore an entire history of possible alcohol intake before then. As people become unwell they may choose to quit drinking or substantially reduce how much they drink. This means that the group of non-drinkers shown to have a higher risk of cardiovascular disease could actually be made up of people who have never drunk alcohol at all, as well as those who used to drink but quit due to ill health. Therefore, we may falsely think alcohol consumption is beneficial for us because healthy moderate drinkers are compared to non-drinkers who may already be ill. Some people may choose to drink alcohol under the belief that it is good for them, but if the current evidence is wrong, then they may actually, unknowingly, be putting themselves at risk. It is also important that we examine the drinking history of those who continue to drink throughout their life too. It may be that there are specific time points in life that drinking is more harmful. If we are able to identify such sensitive periods of the life-course we will be in a better position to take action to ensure that a) those at high risk based on their drinking history are closely monitored (our findings may be used to improve prediction models), and b) strategies are developed to make people aware of this, so that they are able to make informed choices about their drinking habits. The proposed project will use existing data on thousands of people, of different ages, followed up over time to explore these exact issues. How is drinking across the life-course related to developing cardiovascular disease? Is there evidence that moderate drinking is good for the heart when compared to a group of healthy non-drinkers? Are there specific points in life when drinking is most harmful to us? We will use innovative statistical methods to factor in the complex relationship between changes in alcohol consumption and risk of cardiovascular disease, as well as explore how alcohol consumption affects biological markers of cardiovascular disease (such as blood pressure and cholesterol) in order to better understand the pathways through which drinking increases or reduces the risk of developing cardiovascular disease. We will document best practices so that these methods may then be used by others to explore how life-time drinking is associated with different health outcomes. Ultimately, it is hoped that the findings from this work will contribute to a reduction in the number of people who go on to develop or die from cardiovascular diseases by improving our understanding of specific periods of the life-course where prevention strategies may be most useful and developing more sophisticated means of assessing those at high risk.