Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology & Data Science, Amsterdam Cardiovascular Sciences Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands.
Beth Israel Deaconess Medical Center, Harvard Medical School and Harvard TH Chan School of Public Health, Boston, MA, USA.
Curr Atheroscler Rep. 2022 Jan;24(1):51-59. doi: 10.1007/s11883-022-00992-1. Epub 2022 Feb 7.
A clear link between excessive alcohol consumption and cardiovascular disease (CVD) has been established, but no consensus exists on the effects of moderate alcohol consumption on CVD.
A lower risk of coronary heart disease and myocardial infarction among moderate drinkers compared to abstainers has been consistently observed in epidemiological studies and meta-analyses of these studies. However, ambiguity remains on the effect of alcohol on other CVDs and all-cause mortality. Short-term randomized controlled trials (RCT) have identified potentially beneficial effects of alcohol consumption on cardiovascular risk factors, but studies investigating genetic polymorphisms that influence alcohol consumption (i.e., Mendelian randomization) have yielded inconclusive results. To date, a long-term RCT providing causal evidence is lacking but urgently needed. Triangulation of evidence from different study designs, including long-term RCTs, pragmatic trials and the evaluation of policy measures, combined will lead to the best available evidence.
大量饮酒与心血管疾病(CVD)之间存在明确关联,但关于适量饮酒对 CVD 的影响尚无共识。
在流行病学研究和这些研究的荟萃分析中,与戒酒者相比,适量饮酒者患冠心病和心肌梗死的风险较低。然而,酒精对其他 CVD 和全因死亡率的影响仍存在不确定性。短期随机对照试验(RCT)已经发现酒精摄入对心血管危险因素的潜在有益影响,但研究遗传多态性对酒精摄入的影响(即孟德尔随机化)的结果尚无定论。迄今为止,缺乏提供因果证据的长期 RCT,这是迫切需要的。来自不同研究设计的证据的三角测量,包括长期 RCT、实用试验和政策措施的评估,结合起来将提供最佳的现有证据。