Jackson R, Scragg R, Beaglehole R
Department of Community Health School of Medicine, University of Auckland, New Zealand.
BMJ. 1991 Jul 27;303(6796):211-6. doi: 10.1136/bmj.303.6796.211.
To investigate the hypothesis that the apparent protective effect of habitual alcohol consumption on coronary heart disease is due to drinkers at high risk of coronary heart disease becoming non-drinkers.
Case-control population based study. Data were obtained from interviews with patients with non-fatal myocardial infarction and their controls and with the next of kin of those who had died of coronary heart disease and their controls.
Auckland, New Zealand.
Two groups of cases were studied. The first comprised 227 men and 72 women with non-fatal myocardial infarction identified from a population based surveillance programme for coronary heart disease; controls were 525 men and 341 women randomly selected from the same population group and matched for age and sex. The second group comprised 128 men and 30 women who had died of coronary heart disease and had been identified from the surveillance programme; controls were a sample of the previous control group and comprised 330 men and 214 women matched for age and sex. All participants were aged 25-64 years and without diagnosed coronary heart disease.
Regular alcohol consumption; high density lipoprotein cholesterol and low density lipoprotein concentrations.
Men with myocardial infarction and men who had died of coronary heart disease were more likely to have been never drinkers (had never drunk more than once a month) than controls (18% v 12% and 23% v 13% respectively). After possible confounding factors had been controlled for, people in all categories of drinking (up to more than 56 drinks per week) had at least a 40% reduction in risk of fatal and non-fatal coronary heart disease compared with never drinkers. Former drinkers also had a lower risk of non-fatal myocardial infarction than never drinkers (relative risks 0.41 and 0.10 in men and women respectively) but a similar risk of death from coronary heart disease. The reduction in risk was consistently greater in women than in men in all drinking categories but there was no clear dose-response effect in either sex.
The results support the hypothesis that light and moderate alcohol consumption reduces the risk of coronary heart disease. This protective effect in this population was not due to the misclassification of former drinkers with a high risk of coronary heart disease as non-drinkers.
探讨习惯性饮酒对冠心病具有明显保护作用这一假说，即冠心病高危饮酒者转变为不饮酒者。
基于人群的病例对照研究。数据通过对非致死性心肌梗死患者及其对照、死于冠心病者的近亲及其对照进行访谈获得。
新西兰奥克兰。
研究了两组病例。第一组包括从基于人群的冠心病监测项目中识别出的227名男性和72名女性非致死性心肌梗死患者；对照为从同一人群组中随机选取的525名男性和341名女性，按年龄和性别匹配。第二组包括从监测项目中识别出的128名死于冠心病的男性和30名女性；对照是前一组对照组的样本，包括330名男性和214名女性，按年龄和性别匹配。所有参与者年龄在25 - 64岁之间，且无已诊断的冠心病。
规律饮酒情况；高密度脂蛋白胆固醇和低密度脂蛋白浓度。
心肌梗死男性患者和死于冠心病的男性相比对照组更有可能从不饮酒（每月饮酒不超过一次）（分别为18%对12%和23%对13%）。在控制了可能的混杂因素后，各类饮酒者（每周饮酒量高达56杯以上）与从不饮酒者相比，致死性和非致死性冠心病风险至少降低40%。既往饮酒者非致死性心肌梗死风险也低于从不饮酒者（男性和女性的相对风险分别为0.41和0.10），但冠心病死亡风险相似。在所有饮酒类别中，女性风险降低幅度始终大于男性，但两性均无明确的剂量反应效应。
结果支持轻度和中度饮酒可降低冠心病风险这一假说。该人群中的这种保护作用并非由于将冠心病高危的既往饮酒者误分类为不饮酒者。
