Kittner S J, Garcia-Palmieri M R, Costas R, Cruz-Vidal M, Abbott R D, Havlik R J
Am J Epidemiol. 1983 May;117(5):538-50. doi: 10.1093/oxfordjournals.aje.a113576.
The relationship of alcohol consumption, measured in 1965-1968 by the 24-hour recall method, to incident coronary heart disease morbidity at eight years and mortality at 12 years of follow-up was investigated in a cohort of 9150 Puerto Rican males 35-79 years of age. After adjustment for age, cigarettes, exercise, urban/rural status, and income, there was clear evidence of a "U-shaped" relationship between alcohol and total mortality, and also the suggestion of a "J-shaped" relationship for angina pectoris, nonfatal myocardial infarction, and nonsudden coronary heart disease death. There was no association of alcohol with sudden cardiac death. The adjusted odds ratio for drinkers versus nondrinkers was 0.6 for angina pectoris (p less than 0.05), 0.7 for nonfatal myocardial infarction (p less than 0.1), and 0.7 for nonsudden coronary heart disease death (p less than 0.05). The inverse association of alcohol consumption to nonsudden coronary heart disease death was found to be dependent on age and income: the adjusted odds ratio for subjects under age 60 (0.4) or over the median income (0.3) strongly favored drinkers, while there was no evidence for a "protective effect" of alcohol consumption in the older and poorer segments of the population. It is concluded that available evidence does not justify the assertion that the inverse association between moderate alcohol intake and coronary heart disease risk is a causal one.
在一个由9150名年龄在35至79岁之间的波多黎各男性组成的队列中，研究了1965年至1968年通过24小时回顾法测量的酒精摄入量与随访8年时冠心病发病率以及随访12年时死亡率之间的关系。在对年龄、吸烟、运动、城乡状况和收入进行调整后，有明确证据表明酒精与总死亡率之间存在“U型”关系，同时也提示酒精与心绞痛、非致命性心肌梗死和非猝死性冠心病死亡之间存在“J型”关系。酒精与心源性猝死无关联。饮酒者与不饮酒者相比，心绞痛的调整后比值比为0.6（p<0.05），非致命性心肌梗死为0.7（p<0.1），非猝死性冠心病死亡为0.7（p<0.05）。发现酒精摄入量与非猝死性冠心病死亡之间的负相关取决于年龄和收入：60岁以下（0.4）或收入高于中位数（0.3）的受试者的调整后比值比强烈支持饮酒者，而在年龄较大和较贫困的人群中没有证据表明酒精摄入具有“保护作用”。结论是，现有证据不足以证明适度饮酒与冠心病风险之间的负相关是因果关系这一断言。
