Division of Cardiovascular Medicine, Maimonides Medical Center, Brooklyn, NY, USA.
Division of Cardiovascular Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
Curr Cardiol Rep. 2018 Mar 8;20(4):19. doi: 10.1007/s11886-018-0962-2.
This review aims to discuss the effect of alcohol consumption on various cardiovascular (CV) diseases and CV mortality.
Alcohol intake has consistently shown a J- or U-shaped relationship with several cardiovascular diseases. Light to moderate alcohol intake has been associated with lower risk of coronary artery disease, heart failure (HF), as well as CV mortality. On the other hand, heavy consumption has been associated with deleterious CV outcomes including increased mortality. However, the evidence is based from observational and population-based studies where risk of confounding cannot be excluded even after meticulous methodological approaches. This is compounded by conflicting data such as higher risk of certain CV diseases like HF in former drinkers compared to abstainers. Further, Mendelian randomization studies using genetic polymorphisms in enzymes have recently questioned the beneficial association of low-moderate drinking with CV system. There has been substantial and consistent evidence that light to moderate alcohol consumption have beneficial effect on overall cardiovascular profile and mortality. However, there are considerable limitations in the reported literature to determine a strong causality of a protective effect of moderate alcohol consumption by itself. Further robust studies or possibly a well-structured randomized controlled could bring an end to this debate.
本文旨在讨论饮酒对各种心血管疾病和心血管死亡率的影响。
饮酒与多种心血管疾病呈 J 型或 U 型关系。轻度至中度饮酒与冠心病、心力衰竭 (HF) 以及心血管死亡率降低相关。另一方面，大量饮酒与心血管不良结局相关，包括死亡率增加。然而，这些证据来自观察性和基于人群的研究，即使采用细致的方法学方法，也不能排除混杂因素的风险。此外，由于某些观察性研究存在相互矛盾的数据，例如与不饮酒者相比，前饮酒者患 HF 等某些心血管疾病的风险更高，情况变得更加复杂。此外，最近使用酶的遗传多态性进行的孟德尔随机化研究对低中度饮酒与心血管系统有益关联提出了质疑。有大量一致的证据表明，轻度至中度饮酒对整体心血管状况和死亡率有有益影响。然而，报告的文献中有相当大的局限性，无法确定适度饮酒本身具有保护作用的因果关系。进一步的稳健研究或可能是一项结构良好的随机对照试验可能会结束这场争论。
