Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Medicine, Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
J Intern Med. 2017 Oct;282(4):332-339. doi: 10.1111/joim.12630. Epub 2017 Jun 1.
Alcohol consumption and cigarette smoking are modifiable lifestyle factors with important impact on public health. It is unclear whether these factors influence the risk of aortic valve stenosis (AVS).
To investigate the associations of alcohol consumption and smoking, including smoking intensity and time since cessation, with AVS incidence in two prospective cohorts.
This analysis was based on data from the Swedish Mammography Cohort and the Cohort of Swedish Men, comprising 69 365 adults without cardiovascular disease at baseline. Participants were followed for AVS incidence and death by linkage to the Swedish National Patient and Causes of Death Registers. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated by Cox proportional hazards regression.
Over a mean follow-up of 15.3 years, 1249 cases of AVS (494 in women and 755 in men) were recorded. Compared with never drinkers of alcohol (lifelong abstainers), the risk of AVS was significantly lower in current light drinkers (1-6 drinks per week [1 drink = 12 g alcohol]; multivariable HR 0.82; 95% CI: 0.68-0.99). The risk of AVS increased with increasing smoking intensity. Compared with never smokers, the HR was 1.46 (95% CI: 1.16-1.85) in current smokers of ≥30 pack-years. Former smokers who had quit smoking 10 or more years previously had similar risk for AVS as never smokers.
This study suggests that current light alcohol consumption is associated with a lower risk of AVS, and indicates that the association between smoking and AVS risk is reversible.
饮酒和吸烟是可改变的生活方式因素，对公共健康有重要影响。目前尚不清楚这些因素是否会影响主动脉瓣狭窄（AVS）的风险。
研究饮酒和吸烟（包括吸烟强度和戒烟时间）与两个前瞻性队列中 AVS 发病率的相关性。
本分析基于瑞典乳腺队列和瑞典男性队列的数据，包含 69365 名基线时无心血管疾病的成年人。通过与瑞典国家患者和死因登记册的链接，对参与者进行 AVS 发病率和死亡的随访。通过 Cox 比例风险回归估计风险比（HR）及其 95%置信区间（CI）。
在平均 15.3 年的随访期间，共记录到 1249 例 AVS（女性 494 例，男性 755 例）。与从不饮酒的人（终生禁酒者）相比，目前轻度饮酒者（每周 1-6 杯[1 杯=12 克酒精]）的 AVS 风险明显降低（多变量 HR 0.82；95%CI：0.68-0.99）。吸烟强度与 AVS 风险增加相关。与从不吸烟者相比，目前吸烟≥30 包年者的 HR 为 1.46（95%CI：1.16-1.85）。戒烟 10 年或以上的前吸烟者，其患 AVS 的风险与从不吸烟者相似。
本研究表明，目前轻度饮酒与 AVS 风险降低有关，并表明吸烟与 AVS 风险之间的关联是可逆的。
