¿Es bueno el alcohol para la salud?

Josep Guardia Serecigni

Resumen


Algunos estudios observacionales de seguimiento sobre salud cardiovascular han encontrado una coincidencia entre el consumo moderado de alcohol y una menor mortalidad prematura, debida a un infarto de miocardio o a otras causas. Dichos estudios cuentan con importantes limitaciones metodológicas. La mayoría de personas que pertenecían al grupo de abstemios, en realidad eran ex-bebedores, es decir, personas que habían tenido que dejar de beber alcohol debido a que sufrían alguna enfermedad. Además, no se han evaluado otras variables que influyen decisivamente sobre el riesgo cardiovascular como el tabaquismo, el ejercicio físico, el índice de masa corporal y otras; ni tampoco los posibles cambios de los hábitos de consumo de alcohol con el paso de los años. Por lo tanto, las limitaciones del diseño metodológico de dichos estudios sólo permiten hablar de una “asociación” estadística pero no postular supuestas relaciones de causalidad. Además, existen innumerables estudios que han comprobado reiteradamente que el consumo excesivo de alcohol puede causar diversas enfermedades cardiovasculares (hipertensión arterial, arritmias, cardiomiopatía, hemorragia cerebral) y todo tipo de enfermedades médicas y trastornos neuropsiquiátricos. Por otro lado, el alcohol tiene propiedades adictivas que pueden contribuir a que determinadas personas desarrollen involuntariamente un consumo excesivo de alcohol. El mensaje a la población debería enfatizar por tanto el daño potencial del consumo excesivo de alcohol en lugar centrarse en algún posible beneficio del su consumo moderado. El mensaje simplista de que el alcohol puede ser bueno para la salud cardiovascular, se convierte en engañoso cuando se descontextualiza del elevado número de enfermedades que puede causar.


Palabras clave


alcohol; mortalidad prematura; infarto de miocardio; ex-bebedores; enfermedades relacionadas con el alcohol

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Referencias


Klatsky AL, Armstrong MA. Alcoholic beverage choice and risk of coronary artery disease mortality: Do red wine drinkers fare best? Am J Cardiol 1993; 71:467-469.

Doll R, Peto R, Hall E, Wheastley K, Gray R. Mortality in relation to consumption of alcohol: 13 years’ observation on male British doctors. BMJ 1994; 309: 911-918.

Rimm EB, Klatsky A, Grobbee D, Stamfer MJ. Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine or spirits? BMJ 1996; 312:731-736.

Criqui MH, Alcohol and coronary heart disease: consistent relationship and public health implications. Clinica Chimica Acta 1996; 246: 51-57.

Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ 1999; 319:1523-1528.

Berger K, Ajani UA, Kase Cs, et al. Light-to-moderate alcohol consumption and risk of stroke among US male physicians. N Engl J Med 1999; 341:1557-1564.

Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen K. Alcohol and coronary heart disease: a meta-analysis. Addiction 2000; 95:1505-1523.

Gmel G, Gutjahr E, Rehm J. How stable is the risk curve between alcohol and all-cause mortality and what factors influence the shape? A precision-weighted hierarchical meta-analysis. Eur J Epidemiol 2003; 18: 631-641.

Bagnardi V, Zambon A, Quatto P, Corrao G. Flexible meta-regression functions for modeling aggregate dose-response data, with an application to alcohol and mortality. Am J Epidemiol 2004; 159; 1077-1086.

Pendersen JO, Heitmann BL, Schnohr P Gronbaek M. The combined influence of leisure time physical activity and weekly alcohol intake on fatal ischaemic heart disease and all-cause mortality. European Heart Journal 2008; 29:1-9.

Bentzon JF, Skovenborg E, Hansen C et al. Red wine does not reduce mature atherosclerosis in apolipoprotein E-deficient mice. Circulation 2001; 103:1681-1687.

Rehm J, Sempos CT. Alcohol consumption and all-cause mortality. Addiction 1995; 90:471-480.

Fillmore K, Kerr W y Bostrom A. Changes in drinking status, serious illness and mortality. Journal of Studies on Alcohol 2003; 64:278-285.

Shaper AG. Alcohol and mortality: a review of prospective studies. Br J Addict 1990; 85:837-847.

Shaper AG. Alcohol and coronary heart disease. Eur Heart J 1995; 16:1760-1764.

Day N. Alcohol and mortality: separating the drinking from the drinker, PhD thesis Berkeley, University of California, 1978.

Wannamethee SG, Shaper AG. Lifelong teetotallers, ex-drinkers and drinkers: mortality and the incidence of major coronary heart disease events in middle-aged British men. Int J Epidemiol 1997;26:523-531.

Shaper AG, Wannamethee SG. The J-shaped curve and changes in drinking habit. Novartis Found Symp. 1998; 216:173-188.

Shaper AG, Wannamethee SG. Alcohol intake and mortality in middle aged men with diagnosed coronary heart disease. Heart 2000; 83:394-399.

Wannamethee G, Shaper AG. Men who do not drink – a report from the British-Regional-Heart-Study. Int J Epidemiol 1988; 17: 307-316.

Goldberg IJ, Mosca L, Piano MR, Fisher EA. Wine and your heart. A science advisory for healthcare professionals from the Nutrition Committee, Council on Epidemiology and Prevention, and Council on Cardiovascular Nursing of the American Heart Association. Stroke 2001; 103;591-594.

Emberson JR, Shaper AG, Wannamethee SG, Morris RW, Whincup PH. Alcohol intake in middle age and risk of cardiovascular disease and mortality. Accounting for intake variation over time. Am J Epidemiol 2005;

:856-863.

Graham K, Massak A, Demers A, Rehm A. Does the association between alcohol consumption and depression depend on how they are measured? 2007; 31:78-88.

Criqui MH. Alcohol and coronary heart disease risk: implications for public policy. J Stud Alcohol 1997; 58:453-454.

Gall N. Is wine good for your heart? A critical review. Postgrad Med J 2001; 77.172-176.

Emberson JR, Whincup PH, Morris RW, Wannameethee SG, Shaper AG. Lifestyle and cardiovascular disease in middle-aged British men: the effect of adjusting for within-person variation. European Heart Journal 2005;

:1774-1782.

Kannel WB, Ellison RC. Alcohol and coronary heart disease: the evidence for a protective effect. Clin Chim Acta 1996; 246:59-76.

Barrett DH, Anda RF, Croft JB, Serdula MK, Lane MJ. The association between alcohol use and health behaviors related to the risk of cardiovascular disease: The South Carolina Cardivascular Disease Prevention Project. J Stud Alcohol 1995; 56:9-15.

Camacho TC. Alcohol consumption and mortality in Alameda County. J Chron Dis 1987; 40:229-236.

Andréasson S. Alcohol and J-shaped curves. Alcohol Clin Exp Res 1998; 22.359S-364S.

Lau K, Freyer-Adam J, Coder B, Riedel J, et al. Doseresponse relation between volume of drinking and alcohol-related disease in male general hospital inpatients. Alcohol and Alcoholism 2007; 43:34-39.

Okosun IS, Seale JP, Daniel JB, Eriksen MP. Poor health is associated with episodic heavy alcohol use: evidence from National Survey. Public Health 2005; 119:509-517.

Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure: A meta-analysis of randomized controlled trials. Hypertension 2001; 38:1112-1117.

Cherpitel CJ, Tam T, Lorraine M, Caetano R, Greenfield T. Alcohol and non-fatal injury in the U.S. general population: A risk function analysis. Accid Anal Prev 1995; 27:651-661.

Razvodovsky YE. Suicide and alcohol poisoning in Belarus between 1970 and 2005. Adicciones 2007; 19: 423-532.

Willet WC, Stampfer MJ, Colditz GA, rosner BA, Hennekens CH, Speizer FE. Moderate alcohol consumption and the risk of breast cancer. N Engl J Med 1987; 316:1174-1180.

Shin AF, Sjrewsbury RP (eds): Evaluation of Drug Interactions. New York, Macmillan, 1988.

D’Onofrio BM, Van Hulle CA, Waldman ID, Rodgers JL, Rathouz PJ, Lahey BB. Causal inference regarding prenatal alcohol exposure and childhood externalizing problems. Arch Gen Psychiatry 2007; 64:1296-1304.

Razvodovsky YE. Aggregate level time series association between alcohol consumption and cardiovascular mortality. Adicciones 2005; 17: 43-60.

Baros AM, Wright TM, Latham PK, Miller PM, Anton RF. Alcohol consumption, %CDT, GGT, and blood pressure change during alcohol treatment. Alcohol Alcohol 2008; 43: 192-197.

Room R, Babor T, Rehm J. Alcohol and public health. The Lancet 2005; 365 (9458): 519-530.

Witterman JC, Willett WC, Stampfer MJ, et al. Relation of moderate alcohol consumption and risk of systemic hypertension in women Am J Cardiol 1990; 65:633-637.

Klatsky AL, Armstrong MA, Friedman GD. Risk of cardivascular mortality in alcohol drinkers, ex-drinkers and non drinkers. Am J Cardiol 1990; 66:1237-1242.

Babor T, Caetano R, Casswell S, Edwards G, Giesbretcht N, Graham K, Grube J, Grunewald P, Hill L, Holder H, Homel R, Österberg E, Rehm J, Room R, Rossow I. Alcohol: No Ordinary Commodity. Research and public

policy. Oxford University Press. Oxford. 2003.

Anderson P, Baumberg B. El alcohol en Europa. Una perspectiva de salud pública. Institute of Alcohol Studies. Reino Unido. 2006.

Wannamethee SG, Shaper AG. Type of alcoholic drink and risk of major coronary heart disease events and allcause mortality. Am J Public Health 1999; 89:685-690.

Taylor B, Rehm J, Patra J, Popova S, Baliunas D. Alcoholattributable

morbidity and resulting health care costs in Canada in 2002: recommendations for policy and prevention. J Stud alcohol Drugs 2007; 68:36-47.

Koob G, Roberts AJ, Schlteis G, Parsons LH, Heiser ChJ, Hyytia P, Merlo-Pich E, Weiss F. Neurocircuitry targets in ethanol reward and dependence. Alcohol Clin Exp Res 1998; 22:3-9.

Organización Mundial de la Salud. Neuroscience of psychoactive substance use and dependence. World Health Organization. Geneva. 2004. (pp. 69-72)

Saha TD, Chou SP, Grant BF. Toward an alcohol use disorder continuum using item response theory: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychol Med 2006, 36.931-941.

Wannamethee SG, Shaper AG. Alcohol, coronary heart disease and stroke: an examination of the J-shaped curve. Neuroepidemiology 1998; 17:288-295.




DOI: https://doi.org/10.20882/adicciones.264

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