饮酒对心血管系统影响的双向效应争论中的共识与分歧

Consensus and Disagreement in the Debate on the Bidirectional Effects of Alcohol Consumption on the Cardiovascular System

当今世界饮用酒精饮料的人群日益增加。饮酒可诱发多种疾病,对人类健康构成严重威胁,但其对心血管系统是否存在积极影响尚有争议。传统观念认为,少到中等量饮酒(女性每日摄取纯酒精 ≤ 1个标准量,男性每日摄取纯酒精 ≤ 2个标准量,1个标准量=12~15 g纯酒精)可能有益于治疗心血管系统疾病(如动脉粥样硬化性心血管疾病),而过量饮酒(每日摄取纯酒精 > 2个标准量)则会导致心血管系统损害,即“J”型曲线的双向效应。近年来,针对上述传统观念是否正确的争论愈演愈烈,并涉及饮酒方式、酒精饮料类型及所影响的不同类型心血管疾病等诸多方面。本文通过汇总、分析国内外相关研究的最新成果,讨论饮酒对心血管系统影响的双向效应争论中的共识与分歧,发现尽管目前相关研究并未形成一致观点,但多数研究结果提示,少到中等量饮酒可能有益于心血管健康,尤其是对于中老年人及已存在动脉粥样硬化性心血管疾病的患者,可为今后制订与心血管疾病防控相关的生活方式干预指南提供思路。

Today’s world,there is an increasing number of people drinking alcoholic beverages.Drinking alcohol can induce several diseases and is a serious threat to human health,but whether it has a positive effect on the cardiovascular system is controversial.Traditional beliefs have suggested that small to moderate amounts of alcohol consumption (female intake of ≤ 1 standard amounts of alcoholic beverages daily,male intake of ≤ 2 standard amounts of alcoholic beverages daily,1 standard amounts of alcoholic beverages=12-15 g pure ethanol) might be beneficial for the treatment of cardiovascular diseases (such as atherosclerotic cardiovascular disease),whereas heavy drinking (intake of > 2 standard amounts of alcoholic beverages daily) leads to impairment of the cardiovascular system,the bidirectional effect of a “J”-shaped curve.In recent years,there has been a growing debate on whether traditional ideas are correct,involving many aspects such as the pattern of drinking,the type of alcoholic beverage and the different types of CVD that they affect.This article discusses the consensus and disagreement in the debate on bidirectional effects of drinking on cardiovascular system by pooling and analyzing recent results from relevant studies at home and abroad,finding that although there is no consistent view in the current relevant studies,most research results suggest that small to moderate alcohol consumption may benefit cardiovascular health,especially in middle-aged and elderly people with pre-existing atherosclerosis and cardiovascular disease.It may provide ideas for developing lifestyle intervention guidelines for cardiovascular disease prevention and control in the future.