Sesso H D, Stampfer M J, Rosner B, Hennekens C H, Manson J E, Gaziano J M
Brigham and Women's Hospital, 900 Commonwealth Ave E, Boston, MA 02215-1204.
Arch Intern Med. 2000 Sep 25;160(17):2605-12. doi: 10.1001/archinte.160.17.2605.
Few studies have examined whether changes in alcohol consumption influence future cardiovascular risk.
To examine whether 7-year changes in alcohol consumption are associated with the subsequent risk of cardiovascular disease (CVD).
We prospectively followed up 18,455 men aged 40 to 84 years from the Physicians' Health Study with no history of CVD or cancer. Alcohol consumption was reported on the baseline and the 7-year questionnaires; follow-up for this analysis began after the 7-year questionnaire (median follow-up, 5.8 years). There were 1091 CVD cases, including myocardial infarction, angina pectoris, revascularization, stroke, and CVD-related death.
Among men initially consuming 1 drink per week or less (n=7360), those with moderate increases (>1 to <6 drinks per week) in alcohol consumption had a borderline significant (P=.05) 29% reduced risk of CVD compared with men with no changes (-1 to 1 drink per week). Among men initially consuming greater than 1 to 6 drinks per week (n=6612), those with moderate increases had a nonsignificant (P=.32) 15% decrease in CVD risk compared with men with no changes. Finally, among men initially consuming 1 drink per day or more (n=4483), those who increased intake had a 63% increased risk of CVD compared with men with no changes.
These prospective data suggest that, among men with initially low alcohol consumption (</=1 drink per week), a subsequent moderate increase in alcohol consumption may lower their CVD risk. The possible reduction in CVD risk from increasing alcohol intake did not extend to men initially consuming greater than 1 drink per week. Given the potential risks and benefits associated with alcohol consumption, physician counseling of patients must be individualized in the context of the primary prevention of CVD.
很少有研究探讨饮酒量的变化是否会影响未来的心血管疾病风险。
研究饮酒量在7年中的变化是否与随后患心血管疾病（CVD）的风险相关。
我们对来自医师健康研究的18455名年龄在40至84岁之间且无心血管疾病或癌症病史的男性进行了前瞻性随访。在基线和7年问卷中报告饮酒情况；本次分析的随访在7年问卷之后开始（中位随访时间为5.8年）。共有1091例心血管疾病病例，包括心肌梗死、心绞痛、血运重建、中风以及与心血管疾病相关的死亡。
在最初每周饮酒1杯或更少的男性（n = 7360）中，饮酒量适度增加（每周>1至<6杯）的男性与饮酒量无变化（每周-1至1杯）的男性相比，心血管疾病风险降低了29%，差异接近显著（P = 0.05）。在最初每周饮酒大于1至6杯的男性（n = 6612）中，饮酒量适度增加的男性与饮酒量无变化的男性相比，心血管疾病风险降低了15%，差异无统计学意义（P = 0.32）。最后，在最初每天饮酒1杯或更多的男性（n = 4483）中，饮酒量增加的男性与饮酒量无变化的男性相比，心血管疾病风险增加了63%。
这些前瞻性数据表明，在最初饮酒量较低（每周≤1杯）的男性中，随后适度增加饮酒量可能会降低他们患心血管疾病的风险。饮酒量增加可能带来的心血管疾病风险降低并未延伸至最初每周饮酒大于1杯的男性。鉴于饮酒相关的潜在风险和益处，在心血管疾病一级预防的背景下，医生对患者的咨询必须个体化。
