Djoussé Luc, Gaziano J Michael
Division of Aging, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Am J Cardiol. 2008 Sep 1;102(5):593-7. doi: 10.1016/j.amjcard.2008.04.031. Epub 2008 Jun 12.
Although alcohol drinking increases blood pressure and heavy drinking has been associated with alcoholic cardiomyopathy, little is known about the association between light to moderate drinking and risk of heart failure (HF) in hypertensive subjects. Thus, the association between light to moderate drinking and incident HF in 5,153 hypertensive male physicians who were free of stroke, myocardial infarction, or major cancers at baseline was prospectively examined. Alcohol consumption was self-reported and classified as <1, 1 to 4, 5 to 7, and >or=8 drinks/week. HF was ascertained using follow-up questionnaires and validated using Framingham criteria. Average age was 58 years, and about 70% of subjects consumed 1 to 7 drinks/week. A total of 478 incident HF cases occurred in this cohort during follow-up. Compared with subjects consuming <1 drink/week, hazard ratios for HF were 0.89 (95% confidence interval [CI] 0.70 to 1.12), 0.72 (95% CI 0.57 to 0.91), and 0.38 (95% CI 0.20 to 0.72) for alcohol consumption of 1 to 4, 5 to 7, and >or=8 drinks/week after adjustment for age, body mass index, smoking, randomization group, use of multivitamins, vegetable consumption, breakfast cereal, exercise, and history of atrial fibrillation, respectively (p for trend <0.001). Similar results were obtained for subjects with HF with and without antecedent myocardial infarction and those without diabetes mellitus. In conclusion, our data suggested that light to moderate alcohol consumption was associated with a lower risk of HF in hypertensive male physicians.
尽管饮酒会升高血压,大量饮酒与酒精性心肌病有关,但对于轻度至中度饮酒与高血压患者心力衰竭(HF)风险之间的关联却知之甚少。因此,我们前瞻性地研究了5153名基线时无中风、心肌梗死或重大癌症的高血压男性医生中,轻度至中度饮酒与新发HF之间的关联。饮酒情况通过自我报告确定,并分为每周<1杯、1至4杯、5至7杯以及≥8杯。HF通过随访问卷确定,并使用弗雷明汉标准进行验证。平均年龄为58岁,约70%的受试者每周饮酒1至7杯。在随访期间,该队列共发生478例新发HF病例。在调整年龄、体重指数、吸烟、随机分组、多种维生素使用情况、蔬菜摄入量、早餐谷类食物、运动以及房颤病史后,与每周饮酒<1杯的受试者相比,每周饮酒1至4杯、5至7杯以及≥8杯的受试者发生HF的风险比分别为0.89(95%置信区间[CI] 0.70至1.12)、0.72(95%CI 0.57至0.91)和0.38(95%CI 0.20至0.72)(趋势p<0.001)。在有和无前驱心肌梗死的HF患者以及无糖尿病的患者中也获得了类似结果。总之,我们的数据表明,轻度至中度饮酒与高血压男性医生发生HF的风险较低有关。