A PROSPECTIVE-STUDY OF THE HEALTH-EFFECTS OF ALCOHOL-CONSUMPTION IN MIDDLE-AGED AND ELDERLY MEN - THE HONOLULU-HEART-PROGRAM
A PROSPECTIVE-STUDY OF THE HEALTH-EFFECTS OF ALCOHOL-CONSUMPTION IN MIDDLE-AGED AND ELDERLY MEN - THE HONOLULU-HEART-PROGRAM
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DOI：
10.1161/01.cir.89.2.651
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发表时间：
1994-02-01
期刊：
影响因子：
37.8
通讯作者：
CHIU, D
中科院分区：
文献类型：
--
作者：
GOLDBERG, RJ;BURCHFIEL, CM;CHIU, D
背景 该研究的目的是确定在大约 15 年的随访期间，报告的饮酒量与中年（51 至 64 岁）和老年（65 至 75 岁）男性的总死亡率、特定原因死亡率以及非致命性慢性疾病事件之间的关联。方法和结果我们对参加檀香山心脏计划的日裔美国男性进行了一项前瞻性流行病学研究，这些男性在基线检查和 6 年后复查时均未患冠心病、脑血管疾病和癌症。自我报告的饮酒量被确定了两次：1965 年至 1968 年的基线检查和大约 6 年后（1971 年至 1974 年）的复查。考虑了在这两次临床检查时报告相似酒精摄入量的四个主要酒精消费组：戒酒者和轻度（每天 1 至 14 毫升酒精）、中度（每天 15 至 39 毫升酒精）和重度（每天 140 吨酒精）饮酒者。研究终点还针对极少量饮酒者（每天饮酒 1 至 4.9 毫升）以及在两次检查之间报告酒精摄入量发生变化的男性进行确定。纵向随访一直持续到 1988 年底，根据酒精摄入量确定选定的致命和非致命事件。在控制了几个潜在的混杂因素后，中老年男性的总死亡率与饮酒量呈 J 形模式。随着中老年男性饮酒量的增加，致死性和非致死性冠心病合并事件的发生率呈下降趋势。中年男性饮酒量增加与致命性和非致命性中风风险增加有关，而轻度和中度饮酒的老年人患致命性和非致命性中风的风险增加。在所检查的两个年龄组中，酗酒者患致命和非致命恶性肿瘤的风险增加。结论 这项长期前瞻性研究的结果为中老年男性饮酒对健康的影响提供了一个平衡的视角。研究表明，大量饮酒与罹患具有相当公共卫生重要性的疾病的风险增加有关。这些发现表明，考虑到高消费水平带来的相关重大社会和生物问题，在制定提高人口饮酒水平的全民建议时应谨慎行事。
Background The study objective was to determine the association between reported alcohol consumption and total mortality, mortality from selected causes, and incident nonfatal chronic disease events in middle-aged (51 to 64 years old) and elderly (65 to 75 years old) men during an approximate 15-year follow-up period. Methods and Results We conducted a prospective epidemiological study of Japanese-American men who were participating in the Honolulu Heart Program and were free from coronary heart disease, cerebrovascular disease, and cancer at baseline examination and at subsequent reexamination 6 years later. Self-reported alcohol consumption was determined twice: at the baseline examination in 1965 through 1968 and at reexamination approximately 6 years later (1971 through 1974). Four primary alcohol consumption groups who reported similar alcohol intake at the time of these two clinical examinations were considered: abstainers and light (1 to 14 mL of alcohol per day), moderate (15 to 39 mL of alcohol per day), and heavy (140 mt of alcohol per day) drinkers. Study end points were also determined in very light (1 to 4.9 mL of alcohol per day) drinkers and in men who reported a change in their alcohol intake between examinations. Longitudinal follow-up was carried out through the end of 1988 with determination of selected fatal and nonfatal events according to alcohol intake. After controlling for several potentially confounding factors, total mortality exhibited a J-shaped pattern in relation to alcohol consumption in middle-aged and elderly men. There was a trend for lower rates of occurrence of combined fatal and nonfatal coronary heart disease events with increasing alcohol consumption in both middle-aged and elderly men. Increasing alcohol consumption was related to an increased risk of fatal and nonfatal strokes in middle-aged men, whereas elderly light and moderate drinkers were at increased risk for fatal and nonfatal strokes. Heavy drinkers were at increased risk for fatal and nonfatal malignant neoplasms in the two age groups examined. Conclusions The results of this long-term prospective study provide a balanced perspective of the health effects of alcohol consumption in middle-aged and elderly men. High levels of alcohol consumption were shown to be related to an increasing risk of diseases of considerable public health importance. These findings suggest that caution be taken in formulating populationwide recommendations for increases in the population levels of alcohol consumed given the associated significant social and biological problems of high consumption levels.