Prospective study of moderate alcohol consumption and mortality in US male physicians.

BACKGROUND Although moderate alcohol consumption decreases the risk of myocardial infarction, its impact on all-cause mortality among apparently healthy men is unclear. METHODS We performed a prospective cohort study in 22071 men in the Physicians' Health Study. Participants were aged 40 to 84 years and had no history of myocardial infarction, stroke, transient ischemic attack, or cancer. RESULTS There were 1206 deaths (394 cardiovascular, 488 cancer, and 324 other) during 10.7 years of follow-up. Compared with participants who consumed less than 1 drink per week, the relative risk (95% confidence interval) of all-cause mortality for men who consumed 2 to 4 drinks per week was 0.72 (0.59-0.87); 5 to 6 drinks per week, 0.79 (0.64-0.99); 1 drink per day, 0.98 (0.84-1.15); and the highest drinking group (> or = 2 drinks per day), 1.51 (1.17-1.95). This association was similar with either nondrinkers or occasional drinkers used as the reference group and was not subject to material confounding or effect modification by any factor examined. The overall relationship was the result of a J-shaped association with cardiovascular mortality, an increase in cancer deaths for the highest drinking group, and a U-shaped association with other causes of mortality. CONCLUSIONS Risk of all-cause mortality varies by level of alcohol consumption. In this apparently healthy cohort, men who consumed 2 to 6 drinks per week had the most favorable mortality profile and men who had 2 or more drinks per day the most unfavorable mortality profile. The difference between consumption of small and large amounts of alcohol may mean the difference between preventing and causing excess mortality.

背景 尽管适量饮酒可降低心肌梗死的风险，但其对表面健康男性的全因死亡率的影响尚不明确。 方法 我们在医师健康研究中对22071名男性进行了一项前瞻性队列研究。参与者年龄在40至84岁之间，无心肌梗死、中风、短暂性脑缺血发作或癌症病史。 结果 在10.7年的随访期间，共有1206人死亡（394例心血管疾病，488例癌症，324例其他原因）。与每周饮酒少于1杯的参与者相比，每周饮酒2至4杯的男性全因死亡的相对风险（95%置信区间）为0.72（0.59 - 0.87）；每周饮酒5至6杯的为0.79（0.64 - 0.99）；每天饮酒1杯的为0.98（0.84 - 1.15）；而饮酒量最高的组（每天≥2杯）为1.51（1.17 - 1.95）。无论是以不饮酒者还是偶尔饮酒者作为参照组，这种关联都相似，并且不受任何所研究因素的实质性混杂或效应修饰的影响。总体关系是心血管死亡率呈J形关联、饮酒量最高组癌症死亡增加以及其他死因呈U形关联的结果。 结论 全因死亡风险因饮酒量水平而异。在这个表面健康的队列中，每周饮酒2至6杯的男性死亡率情况最有利，而每天饮酒2杯或更多的男性死亡率情况最不利。少量饮酒和大量饮酒之间的差异可能意味着预防和导致过高死亡率之间的差异。