Stampfer M J, Colditz G A, Willett W C, Speizer F E, Hennekens C H
Channing Laboratory, Department of Medicine, Harvard Medical School, Boston, MA 02115.
N Engl J Med. 1988 Aug 4;319(5):267-73. doi: 10.1056/NEJM198808043190503.
In 1980, 87,526 female nurses 34 to 59 years of age completed a dietary questionnaire that assessed their consumption of beer, wine, and liquor. By 1984, during 334,382 person-years of follow-up, we had documented 200 incident cases of severe coronary heart disease (164 nonfatal myocardial infarctions and 36 deaths due to coronary disease), 66 ischemic strokes, and 28 subarachnoid hemorrhages. Follow-up was 98 percent complete. As compared with nondrinkers, women who consumed 5 to 14 g of alcohol per day (three to nine drinks per week) had a relative risk of coronary disease of 0.6 (95 percent confidence interval, 0.4 to 0.9); for 15 to 24 g per day the relative risk was 0.6 (0.3 to 1.1), and for 25 g or more per day it was 0.4 (0.2 to 0.8), after adjustment for risk factors for coronary disease. Alcohol intake was also associated with a decreased risk of ischemic stroke. For 5 to 14 g of alcohol per day the relative risk was 0.3 (0.1 to 0.7), and for 15 g per day or more it was 0.5 (0.2 to 1.1). In contrast, although the number of cases of subarachnoid hemorrhage was small, alcohol intake tended to be associated with an increased risk of this disorder; for 5 to 14 g per day the relative risk was 3.7 (1.0 to 13.8). These prospective data suggest that among middle-aged women, moderate alcohol consumption decreases the risks of coronary heart disease and ischemic stroke but may increase the risk of subarachnoid hemorrhage.
1980年,87526名年龄在34至59岁之间的女护士填写了一份饮食调查问卷,该问卷评估了她们啤酒、葡萄酒和烈酒的摄入量。到1984年,在334382人年的随访期间,我们记录了200例严重冠心病的发病病例(164例非致命性心肌梗死和36例冠心病死亡)、66例缺血性中风和28例蛛网膜下腔出血。随访完成率为98%。与不饮酒者相比,每天摄入5至14克酒精(每周三至九杯)的女性患冠心病的相对风险为0.6(95%置信区间,0.4至0.9);每天摄入15至24克酒精时,相对风险为0.6(0.3至1.1),每天摄入25克或更多酒精时,相对风险为0.4(0.2至0.8),在对冠心病风险因素进行调整后。酒精摄入量还与缺血性中风风险降低有关。每天摄入5至14克酒精时,相对风险为0.3(0.1至0.7),每天摄入15克或更多酒精时,相对风险为0.5(0.2至1.1)。相比之下,尽管蛛网膜下腔出血的病例数较少,但酒精摄入量往往与这种疾病风险增加有关;每天摄入5至14克酒精时,相对风险为3.7(1.0至13.8)。这些前瞻性数据表明,在中年女性中,适度饮酒可降低冠心病和缺血性中风的风险,但可能会增加蛛网膜下腔出血的风险。