King Dana E, Mainous Arch G, Geesey Mark E
Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
Am J Med. 2008 Mar;121(3):201-6. doi: 10.1016/j.amjmed.2007.12.004.
Moderate alcohol use is part of a healthy lifestyle, yet current guidelines caution nondrinkers against starting to drink alcohol in middle age. The purpose of this study was to evaluate whether adopting moderate alcohol consumption in middle age would result in subsequent lower cardiovascular risk.
This study examined a cohort of adults aged 45-64 years participating in the Atherosclerosis Risk in Communities study over a 10-year period. The primary outcome was fatal or nonfatal cardiovascular events.
Of 7697 participants who had no history of cardiovascular disease and were nondrinkers at baseline, within a 6-year follow-up period, 6.0% began moderate alcohol consumption (2 drinks per day or fewer for men, 1 drink per day or fewer for women) and 0.4% began heavier drinking. After 4 years of follow-up, new moderate drinkers had a 38% lower chance of developing cardiovascular disease than did their persistently nondrinking counterparts. This difference persisted after adjustment for demographic and cardiovascular risk factors (odds ratio 0.62, 95% confidence interval, 0.40-0.95). There was no difference in all-cause mortality between the new drinkers and persistent nondrinkers (odds ratio 0.71, 95% confidence interval, 0.31-1.64).
People who newly begin consuming alcohol in middle age rarely do so beyond recommended amounts. Those who begin drinking moderately experience a relatively prompt benefit of lower rates of cardiovascular disease morbidity with no change in mortality rates after 4 years.
适度饮酒是健康生活方式的一部分,但当前指南告诫不饮酒者不要在中年开始饮酒。本研究的目的是评估中年开始适度饮酒是否会降低随后的心血管疾病风险。
本研究调查了一组年龄在45 - 64岁之间、参与社区动脉粥样硬化风险研究长达10年的成年人。主要结局是致命或非致命的心血管事件。
在7697名无心血管疾病史且基线时不饮酒的参与者中,在6年随访期内,6.0%的人开始适度饮酒(男性每天饮酒2杯或更少,女性每天饮酒1杯或更少),0.4%的人开始大量饮酒。随访4年后,新的适度饮酒者患心血管疾病的几率比持续不饮酒者低38%。在对人口统计学和心血管危险因素进行调整后,这种差异仍然存在(优势比0.62,95%置信区间,0.40 - 0.95)。新饮酒者和持续不饮酒者的全因死亡率没有差异(优势比0.71,95%置信区间,0.31 - 1.64)。
中年新开始饮酒的人很少超过推荐饮酒量。开始适度饮酒的人相对较快地受益于较低的心血管疾病发病率,4年后死亡率没有变化。