Woodward M, Tunstall-Pedoe H
Cardiovascular Epidemiology Unit, Ninewells Hospital and Medical School, Dundee.
J Epidemiol Community Health. 1995 Aug;49(4):354-62. doi: 10.1136/jech.49.4.354.
To measure the relationship between reported alcohol consumption and prevalent diagnosed and undiagnosed coronary heart disease (CHD) in men and women to see how much could be explained by covariation with diet, lifestyle, and biomedical factors.
This was a cross sectional, random population survey covering 22 districts of Scotland and using general practitioner patient lists as the sampling frame. Odds ratios for prevalent CHD at different levels of alcohol consumption taken from a seven day recall were analysed. These ratios were then adjusted for lifestyle and biomedical factors.
Male and female responders aged 40-59 years who completed the survey questionnaire and attended the survey clinic.
The participation rate of those invited was 74%. Of the 10,359 responders, 658 were excluded because of missing alcohol data or ambiguous cardiovascular status. The questionnaire was used to designate 7058 drinkers and 2643 non-drinkers, who were then classified as having diagnosed or undiagnosed CHD, or who were controls. The prevalence of diagnosed CHD decreased with increasing alcohol consumption while undiagnosed CHD had a "U" shaped relationship. Patterns were similar in men and women if allowance was made for the lower alcohol consumption in women. Adjustment for several diet and lifestyle factors and for additional biomedical factors reduced the apparent protective effect of alcohol, leaving a modest but statistically insignificant (p > 0.05) reduction in CHD prevalence among light to moderate consumers compared with those who drank no alcohol. Wine drinkers seemed to be at lower risk than beer drinkers in both sexes.
These results tend to confirm that intermediate alcohol consumption is a component and contributor to a low coronary risk lifestyle. Its effects are largely explained by adjusting for both confounding lifestyle associations and for biomedical effects but the remaining effect, and the lower risk with wine drinking compared with beer, are intriguing. Advice on alcohol habits should not be determined solely by the moderate apparent benefit to risk of CHD, however, as other disease risks cannot be ignored.
测量报告的酒精摄入量与男性和女性中已诊断和未诊断的冠心病（CHD）患病率之间的关系，以了解饮食、生活方式和生物医学因素的协变量能解释多少这种关系。
这是一项横断面随机人群调查，涵盖苏格兰的22个地区，并以全科医生的患者名单作为抽样框架。分析了从7天回忆中得出的不同酒精摄入量水平下CHD患病率的比值比。然后对这些比值比进行生活方式和生物医学因素的调整。
年龄在40 - 59岁之间、完成调查问卷并参加调查诊所的男性和女性应答者。
受邀者的参与率为74%。在10359名应答者中，658人因酒精数据缺失或心血管状况不明确而被排除。通过问卷将7058名饮酒者和2643名非饮酒者分为已诊断或未诊断CHD者或对照组。已诊断CHD的患病率随酒精摄入量增加而降低，而未诊断CHD呈“U”形关系。如果考虑到女性酒精摄入量较低的情况，男性和女性的模式相似。对多种饮食和生活方式因素以及其他生物医学因素进行调整后，酒精的明显保护作用减弱，与不饮酒者相比，轻度至中度饮酒者的CHD患病率有适度但无统计学意义（p>0.05）的降低。在两性中，葡萄酒饮用者的风险似乎低于啤酒饮用者。
这些结果倾向于证实适度饮酒是低冠心病风险生活方式的一个组成部分和促成因素。通过调整混杂的生活方式关联和生物医学效应，其影响在很大程度上得到了解释，但剩余效应以及葡萄酒饮用与啤酒相比风险较低的情况很有趣。然而，关于饮酒习惯的建议不应仅由对CHD风险的适度明显益处来决定，因为其他疾病风险也不能忽视。
