Niccoli Giampaolo, Bacà Marco, Cosentino Nicola, Fabretti Alessandro, Crea Filippo
Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma.
Recenti Prog Med. 2008 Nov;99(11):565-71.
Most world populations consume alcoholic beverages. Ethanol may have both protective and harmful effects on health depending on the amount and way of consumption. An extensive body of data shows concordant J or U-shaped associations between alcohol intake and a variety of adverse health outcomes, including coronary heart disease, diabetes, hypertension, congestive heart failure, stroke, and all-cause mortality. In particular, moderate ethanol consumption is associated with cardioprotective benefits such as lower cardiovascular risk and mortality, probably mediated by beneficial effects on inflammation, lipids, and coagulation. In contrast, binge and/or heavy drinking results in proportional worsening of outcomes, increasing cardiovascular events and mortality. This harmful effect has been recently associated with the blockade of ischemic preconditioning mediated by high doses of ethanol. In this review, we highlight the recent epidemiological and experimental evidences regarding the specific benefits and risks of ethanol in the setting of ischemic heart disease.
世界上大多数人群都饮用含酒精饮料。根据饮酒量和饮酒方式的不同,乙醇对健康可能既有保护作用也有有害作用。大量数据表明,酒精摄入量与包括冠心病、糖尿病、高血压、充血性心力衰竭、中风和全因死亡率在内的多种不良健康结局之间呈一致的J形或U形关联。特别是,适度饮用乙醇具有心脏保护作用,如降低心血管风险和死亡率,这可能是通过对炎症、脂质和凝血的有益作用介导的。相比之下,暴饮和/或大量饮酒会导致结局成比例恶化,增加心血管事件和死亡率。最近发现这种有害作用与高剂量乙醇介导的缺血预处理阻断有关。在这篇综述中,我们重点介绍了近期关于乙醇在缺血性心脏病背景下的具体益处和风险的流行病学和实验证据。