Rehm J T, Bondy S J, Sempos C T, Vuong C V
Addiction Research Foundation, Toronto, Ontario, Canada.
Am J Epidemiol. 1997 Sep 15;146(6):495-501. doi: 10.1093/oxfordjournals.aje.a009303.
Alcohol consumption is associated with a reduced risk of coronary heart disease (CHD) but an increased risk of other causes of morbidity and mortality. It remains unclear whether there is an upper limit to a protective effect of alcohol intake on CHD risk. Whether there is a U- or an L-shaped relation between alcohol consumption and CHD incidence (hospitalization and mortality due to ischemic heart disease: International Classification of Diseases codes 410-414) is examined using the National Health and Nutrition Examination Survey I. Baseline data were collected in 1971-1975. Follow-up data through 1987 (14.6 years mean follow-up) were analyzed for 6,788 European-American males (n = 2,960) and females (n = 3,828) aged 40-75 years at baseline. Cox regression was used to assess the association between alcohol consumption and incidence of CHD. For females, an increased risk was found above 28 drinks per week relative to abstainers (relative risk = 2.6, 95% confidence interval 1.2-5.5), which was significant, but was based on small numbers. For males, no upturn in risk was found at higher intake. Mortality data supported these results. Sex differences should be explored further, since they are relevant to understanding causal mechanisms and public policy and prevention.
饮酒与冠心病（CHD）风险降低相关，但与其他发病和死亡原因的风险增加有关。目前尚不清楚酒精摄入量对冠心病风险的保护作用是否存在上限。利用第一次全国健康和营养检查调查来研究饮酒与冠心病发病率（因缺血性心脏病住院和死亡：国际疾病分类代码410 - 414）之间是否存在U型或L型关系。基线数据于1971 - 1975年收集。对基线时年龄在40 - 75岁的6788名欧美男性（n = 2960）和女性（n = 3828）进行了截至1987年（平均随访14.6年）的随访数据分析。采用Cox回归评估饮酒与冠心病发病率之间的关联。对于女性，每周饮酒超过28杯者相对于戒酒者风险增加（相对风险 = 2.6，95%置信区间1.2 - 5.5），这具有显著性，但基于少量样本。对于男性，在较高饮酒量时未发现风险上升。死亡率数据支持了这些结果。性别差异应进一步探讨，因为这与理解因果机制以及公共政策和预防相关。
