Palatini Paolo, Mos Lucio, Saladini Francesca, Vriz Olga, Fania Claudio, Ermolao Andrea, Battista Francesca, Canevari Mattia, Rattazzi Marcello
Department of Medicine, University of Padova, 35128 Padova, Italy.
San Antonio Hospital, 33038 San Daniele del Friuli, Italy.
J Clin Med. 2023 Apr 9;12(8):2792. doi: 10.3390/jcm12082792.
To evaluate the association of alcohol and smoking combined with cardiovascular and renal events and investigate whether moderate and heavy alcohol consumption have a different impact on this association.
The study was conducted in 1208 young-to-middle-age stage 1 hypertensive patients. Subjects were classified into three categories of cigarette smoking and alcohol use, and the risk of adverse outcomes was assessed over a 17.4-year follow-up.
In multivariable Cox models, smoking showed a different prognostic impact on alcohol drinkers and abstainers. In the former, an increase in the risk of cardiovascular and renal events was observed compared to nonsmokers (hazard ratio, 2.6, 95% CI, 1.5-4.3, < 0.001), whereas in the latter, the risk did not achieve the level of statistical significance ( = 0.27) with a significant interaction between smoking and alcohol use ( < 0.001). Among the heavy smokers who also drank alcoholic beverages, the hazard ratio from the fully adjusted model was 4.3 (95% CI, 2.3-8.0, < 0.0001). In the subjects with moderate alcohol consumption, the risk of smoking and alcohol combined was similar to that found in the whole population (hazard ratio, 2.7; 95% CI, 1.5-3.9, < 0.001). Among the subjects with heavy alcohol consumption, the hazard ratio was 3.4 (95% CI, 1.3-8.6, = 0.011).
These findings indicate that the detrimental cardiovascular effects of smoking can be worsened by concomitant alcohol use. This synergistic effect occurs not only for heavy alcohol consumption but also for moderate use. Smokers should be aware of the increased risk associated with concomitant alcohol consumption.
评估饮酒与吸烟相结合与心血管和肾脏事件之间的关联，并调查中度和重度饮酒对这种关联是否有不同影响。
该研究针对1208名中青年1期高血压患者进行。受试者被分为吸烟和饮酒的三类，并在17.4年的随访期间评估不良结局的风险。
在多变量Cox模型中，吸烟对饮酒者和戒酒者显示出不同的预后影响。在前者中，与不吸烟者相比，观察到心血管和肾脏事件风险增加（风险比，2.6，95%置信区间，1.5 - 4.3，<0.001），而在后者中，风险未达到统计学显著水平（P = 0.27），吸烟与饮酒之间存在显著交互作用（P < 0.001）。在同时饮酒的重度吸烟者中，完全调整模型的风险比为4.3（95%置信区间，2.3 - 8.0，<0.0001）。在中度饮酒的受试者中，吸烟和饮酒相结合的风险与整个人群中的风险相似（风险比，2.7；95%置信区间，1.5 - 3.9，<0.001）。在重度饮酒的受试者中，风险比为3.4（95%置信区间，1.3 - 8.6，P = 0.011）。
这些发现表明，吸烟对心血管的有害影响可因同时饮酒而加剧。这种协同效应不仅发生在重度饮酒时，中度饮酒时也会发生。吸烟者应意识到同时饮酒会增加相关风险。
