Cleophas T J, Tuinenberg E, van der Meulen J, Zwinderman K H
Department of Medicine, Merwede Hospital, Dordrecht, The Netherlands.
Angiology. 1996 Aug;47(8):789-96. doi: 10.1177/000331979604700806.
In France there are few cardiac deaths in spite of high animal fat intake. France and Italy have the highest overall intake of alcohol in the world. Obviously, there is an inverse association between coronary heart disease (CHD) and alcohol intake in these countries. Although in the past decade several-large scale population studies have confirmed the beneficial effect of alcohol on CHD, these studies may not have been sensitive to control all the confounding variables. No one so far has explored the possibility that the French may be protected by their low level of life stress. In 1993 we conducted a case-control study (n = 118) to examine psychological variables in a group of Dutch males under sixty years of age, before and after acute myocardial infarction (MI). After adjustment for total cholesterol, blood pressure, and smoking, a number of psychological factors appeared to be independently associated with an increased risk of MI. For the present study the same group of patients was assessed for consumption of different types of alcoholic beverages, coffee, sugar, high-fat diet, and vegetables. In the univariate analysis patients appeared to have consumed more red wine (odds ratio [OR] 0.2, P = 0.03) and controls more spirits (OR 4.0, P = 0.005). After adjustment for total cholesterol, blood pressure, and smoking as well as the independent psychological factors, red wine lost its significance (OR 0.4, P = 0.17) whereas the OR for spirits even rose (OR 6.0, P = 0.01). The beneficial effect of wine may be an expression of a relatively low level of life stress. Alcohol itself is not protective but rather a strong risk factor of MI.
在法国，尽管动物脂肪摄入量很高，但心脏疾病导致的死亡人数却很少。法国和意大利是世界上酒精总体摄入量最高的国家。显然，在这些国家，冠心病（CHD）与酒精摄入量之间存在负相关关系。尽管在过去十年中，几项大规模的人群研究证实了酒精对冠心病有有益影响，但这些研究可能没有足够敏感地控制所有混杂变量。到目前为止，还没有人探讨过法国人可能因其较低的生活压力水平而受到保护的可能性。1993年，我们进行了一项病例对照研究（n = 118），以检查一组60岁以下荷兰男性在急性心肌梗死（MI）前后的心理变量。在对总胆固醇、血压和吸烟情况进行调整后，一些心理因素似乎与心肌梗死风险增加独立相关。在本研究中，对同一组患者评估了不同类型酒精饮料、咖啡、糖、高脂肪饮食和蔬菜的摄入量。在单变量分析中，患者似乎饮用了更多红酒（优势比[OR] 0.2，P = 0.03），而对照组饮用了更多烈酒（OR 4.0，P = 0.005）。在对总胆固醇、血压、吸烟以及独立的心理因素进行调整后，红酒失去了其显著性（OR 0.4，P = 0.17），而烈酒的OR甚至上升了（OR 6.0，P = 0.01）。葡萄酒的有益作用可能是生活压力水平相对较低的一种表现。酒精本身并无保护作用，反而更是心肌梗死的一个强大风险因素。
