Kaiser Permanente Medical Care Program, Oakland, CA, USA.
Physiol Behav. 2010 Apr 26;100(1):76-81. doi: 10.1016/j.physbeh.2009.12.019. Epub 2009 Dec 31.
The substantial medical risks of heavy alcohol drinking as well as the probable existence of a less harmful or safe drinking limit have been evident for centuries. Modern epidemiology studies suggest lowered risk of morbidity and mortality among lighter drinkers. Thus, defining "heavy" drinking as > or =3 standard drinks per day, the alcohol-mortality relationship is a J-curve with risk highest for heavy drinkers, lowest for light drinkers and intermediate for abstainers. A number of non-cardiovascular and cardiovascular problems contribute to the increased mortality risk of heavier drinkers. The lower risk of light drinkers is due mostly to lower risk of the most common cardiovascular condition, coronary heart disease (CHD). These disparate relationships of alcoholic drinking to various cardiovascular and non-cardiovascular conditions constitute a modern concept of alcohol and health. Increased cardiovascular risks of heavy drinking include: (1) alcoholic cardiomyopathy, (2) systemic hypertension (high blood pressure), (3) heart rhythm disturbances, and (4) hemorrhagic stroke. Lighter drinking is not clearly related to increased risk of any cardiovascular condition and, in observational studies, is related to lower risk of CHD, ischemic stroke, and diabetes mellitus. A protective hypothesis for CHD is supported by evidence for plausible biological mechanisms attributable to ethyl alcohol. International comparisons and some prospective study data suggest that wine is more protective against CHD than liquor or beer. Possible non-alcohol beneficial components in wine (especially red) support possible extra protection by wine, but a healthier pattern of drinking or more favorable risk traits in wine drinkers may be involved.
长期大量饮酒会对身体造成严重的医学风险，而且可能存在一个危害较小或安全的饮酒限度。几个世纪以来，这一点已经显而易见。现代流行病学研究表明，轻度饮酒者的发病和死亡率风险较低。因此，将“重度”饮酒定义为每天>或=3 标准饮品，那么酒精与死亡率之间的关系呈 J 型曲线，重度饮酒者的风险最高，轻度饮酒者的风险最低，而戒酒者的风险处于中间。许多非心血管和心血管问题导致重度饮酒者的死亡率风险增加。轻度饮酒者的风险较低主要是因为其患最常见的心血管疾病——冠心病的风险较低。饮酒与各种心血管和非心血管疾病之间的这种不同关系构成了酒精与健康的现代概念。重度饮酒会增加心血管风险，包括：（1）酒精性心肌病，（2）系统性高血压（高血压），（3）心律不齐，以及（4）出血性中风。轻度饮酒与任何心血管疾病风险的增加都没有明确关系，而且在观察性研究中，与冠心病、缺血性中风和糖尿病的风险降低有关。冠心病的保护假说得到了归因于乙醇的合理生物学机制的证据的支持。国际比较和一些前瞻性研究数据表明，与白酒或啤酒相比，葡萄酒对冠心病的保护作用更强。葡萄酒（尤其是红葡萄酒）中可能存在非酒精有益成分，这可能为葡萄酒提供额外的保护，但可能涉及更健康的饮酒模式或葡萄酒饮用者更有利的风险特征。
