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饮酒与心血管疾病:美国心脏协会的科学声明。

Alcohol Use and Cardiovascular Disease: A Scientific Statement From the American Heart Association.

作者信息

Piano Mariann R, Marcus Gregory M, Aycock Dawn M, Buckman Jennifer, Hwang Chueh-Lung, Larsson Susanna C, Mukamal Kenneth J, Roerecke Michael

出版信息

Circulation. 2025 Jul 8;152(1):e7-e21. doi: 10.1161/CIR.0000000000001341. Epub 2025 Jun 9.

Abstract

Alcohol is one of the most commonly consumed substances in the world, exhibiting complex relationships with multiple aspects of cardiovascular health and disease. The majority of the research on the topic is observational and therefore prone to bias and confounding. The available evidence suggests no risk to possible risk reduction when alcohol is consumed in low amounts (such as no more than 1 to 2 drinks a day) in regard to coronary artery disease, stroke, sudden death, and possibly heart failure. The risk associated with consuming 1 to 2 drinks a day on atrial fibrillation remains unknown. More randomized trials of low to moderate alcohol consumption are needed for more definitive conclusions. In stark contrast, heavier alcohol consumption such as binge drinking or consuming on average ≥3 drinks a day is consistently associated with worse outcomes in every cardiovascular disease entity studied. Considering the level of evidence, it remains unknown whether drinking is part of a healthy lifestyle and therefore clinicians should reinforce healthy lifestyle behaviors such as regularly engaging in physical activity, avoiding tobacco use, and maintaining healthy body weight.

摘要

酒精是世界上最常消费的物质之一,与心血管健康和疾病的多个方面呈现出复杂的关系。关于该主题的大多数研究都是观察性的,因此容易产生偏差和混淆。现有证据表明,就冠状动脉疾病、中风、猝死以及可能的心力衰竭而言,少量饮酒(如每天不超过1至2杯)没有风险,甚至可能降低风险。每天饮用1至2杯酒与心房颤动相关的风险尚不清楚。需要更多低至中度饮酒的随机试验才能得出更明确的结论。与之形成鲜明对比的是,大量饮酒,如暴饮或平均每天饮用≥3杯酒,在每项所研究的心血管疾病中都始终与更差的结果相关。考虑到证据水平,饮酒是否属于健康生活方式的一部分仍然未知,因此临床医生应强化健康的生活方式行为,如定期进行体育活动、避免吸烟和保持健康体重。

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