Análisis de series temporales de nivel agregado sobre la asociación entre el consumo de alcohol y la mortalidad cardiovascular
DOI:
https://doi.org/10.20882/adicciones.386Palabras clave:
consumo de alcohol, mortalidad cardiovascular, efecto de una bebida específica, análisis de series temporalesResumen
Las pruebas epidemiológicas constatan la existencia de una relación en forma de J o U entre el nivel de consumo de alcohol y el índice de mortalidad cardiovascular (CDV) con un riesgo elevado para abstemios y bebedores de grandes cantidades de alcohol. El papel del modelo de consumo de alcohol en la asociación entre mortalidad cardiovascular y alcohol es, en la actualidad, una cuestión muy relevante. Sabemos que el consumo esporádico abusivo aumenta de forma lineal el riesgo de CDV. Se ha centrado bastante la atención en el efecto de una bebida específica en el índice de mortalidad cardiovascular. Parece difícil generalizar sobre el efecto de una bebida alcohólica determinada en el índice de mortalidad cardiovascular en la población. Objetivo: Evaluar el efecto de una bebida específica de alcohol en el índice de mortalidad CDV. Método: En Belarús, se analizaron las tendencias de los diferentes tipos de índice de mortalidad CDV (isquemias coronarias, infartos de miocardio e hipertensión) entre 1970 y 1999 en relación con las tendencias en el nivel de consumo per cápita de distintas bebidas alcohólicas, empleando análisis de series temporales, de factores y de grupos. Resultados: Los análisis demostraron el efecto positivo y estadísticamente significativo de los cambios en el consumo per cápita de bebidas de alto contenido alcohólico sobre el índice de mortalidad cardiovascular. Los análisis indican que un aumento del 1% en el consumo de bebidas de alta graduación supone un aumento del 0,45% en el índice de mortalidad por infarto de miocardio y del 0,4% en el índice de mortalidad por hipertensión. Conclusión: Los resultados del presente estudio indican que la mortalidad cardiovascular tiende a ser más sensible a los cambios en el consumo per cápita de bebidas de alto contenido alcohólico que a los cambios en el nivel de consumo total de alcohol en aquellos países donde el patrón de consumo imperante es beber hasta intoxicarse. Este estudio corrobora la idea de que consumir alcohol hasta la intoxicación es un factor de riesgo en la mortalidad cardiovascular de la población.Citas
Arkwright P, Beilin L, Vandongen J. (1984) Alcohol and
hypertension. Aust N Z J Medicine, 14, 463-69.
Baruah J, Kinder D. (1988) Ethanol induced cardiomyopathy
- role of periodic fasting. Exp. Pathol, 33, 201-206.
Bovet P, Paccaud F. (2001) Commentary: alcohol, coronary
heart disease and public health: which evidence-based policy. Int J Epidemiol, 30, 734-37.
Britton A, McKee M. (2000) The relation between alcohol and cardiovascular disease in Eastern Europe. Explaining the paradox. J. Epidemiol Community Health, 54, 328-332.
Caputo F, Lorenzini F, Bernardi G, Stefanini F. (2002) Moderate alcohol intake and reduced risk of coronary heart disease: type or pattern of alcohol consumption? Alcologia, 13, 107-113.
Chenet L, Britton A. (2001) Weekend binge drinking may
be linked to Monday peaks in cardiovascular deaths. BMJ, 349, 322-28.
Chenet L, McKee M, Leon D, Shkolnikov V, Vassin S. (2001) Alcohol and cardiovascular mortality in Moscow: new evidence of a causal association. J Epidemiol Community Health, 52, 772-74.
Cockerhman WC. (2000) Health lifestyles in Russia. Soc. Sci. Med., 51, 1313-24.
Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen
K. (2000) Alcohol and coronary heart disease: a metaanalysis.
Addiction 95, 1505-23.
Donahue R. P. (1986) Alcohol and hemorrhagic stroke. JAMA 255, 2311-2314.
Duthie GG, Pedersen MW, Gardner RT, et al. (1998) The effect of whisky and wine consumption on total phenol content and antioxidant capacity of plasma from healthy volunteers. Eur J Clin Nutr 52, 733-36.
Evans C, Chalmers J, Capewell S, Redpath A, Finlayson A,
Boyd J. (2000) “I don’t like Mondays” day of the week of coronary heart disease deaths in Scotland: study of routinely collected data. BMJ, 327, 218-19.
Frankel EN, Kanner J, German JB, Parks E, Kinsella JE
(1993) Inhibition of oxidation of human low-density lipoprotein by phenolic substances in red wine. Lancet, 341, 454-57.
Fridman LA, Kimball AW (1986) Coronary heart disease
mortality and alcohol consumption in Framingham. Am J Epidemiol 124:481-89.
Gleiberman L, Harburg E (1986) Alcohol usage and blood
pressure; a review. Hum Biol, 58, 1-31.
Grombaek M, Deis A, Sorensen TA, Becker U, Schnohr
P, Jensen G. (1995) Mortality associated with moderate intakes of wine, beer, or spirits. BMJ, 310, 1165-69.
Gronback M, Dies A, Sorensen TA, Becker U, Schnohor P,
Jensen G. (1995) Mortality associated with moderate intakes of wine, beer, or spirits. BMJ, 310, 1165-69.
Hart CL, Smith GP, Hole PJ Hawthorne VM. (1999) Alcohol
consumption and mortality from all causes, coronary heart disease, and stroke: results from a prospective cohort study of
Scottish men with 21 years of follow up. BMJ 318,1725-29.
Hemstrom O. (2001) Per capita alcohol consumption and
ischemic heart disease mortality. Addiction, 96, 93-112.
Honigman B. (1984) Alcoholic myopathy in cardiac and
skeleton muscle. Top. Emergency Med, 6, 66-73.
Hulley SB, Gordon S. (1981) Alcohol and high density
lipoprotein cholesterol. Causal inference from diverse study designs. Circulation, 64, 57-63.
Kamisima H. (1987) Alcohol and hypertension. J Public
Health Pract, 51, 655-660.
Kauhanen J, Kaplan GA, Goldberg DE, Salonen JT. (1997a)
Beer binging and mortality: results from the Kuopio ischaemic heart disease risk factor study, a prospective population based study. BMJ, 315, 846-51.
Kauhanen J, Kaplan GA, Goldberg PD, Cohen RD, Lakka TA, Salonen JT. (1997b) Frequent hangovers and cardiovascular mortality in middle-aged men. Epidemiol, 8, 310-14.
Kittner SJ, Garcia PM, Costas RJ, Cruz VM, Abbot RD,
Havlik RJ. (1983) Alcohol and coronary heart disease in Puerto Rico. Am. J. Epidemiol, 117, 538-50.
Klatsky AL, Armstrong MA, Friedman GB. (1990) Risk of
cardiovascular mortality in alcohol drinkers, ex-drinkers and nondrinkers. Am J Cardiol, 66, 1237-42.
Klatsky AL, Armstrong MA, Friedman GP. (1992) Alcohol
and mortality. Ann Intern Med 117, 646-54.
Klatsky AL, Armstrong MA, Friedman GD. (1997) Red
wine, white wine, liquor, beer, and risk for coronary artery disease hospitalization. Am J Cardiol 80:416-20.
Kupari M, Koskinen P. Alcohol, cardiac arrhythmia and
sudden death. In: Alcohol and cardiovascular diseases (Chadwick D.J. ed.). 1998, 68-79.
Lang RM (1985) Adverse cardiac effects of acute alcohol
ingestion in young adults. Ann Intern Med 102: 742-747.
Law M, Wald N. (1999) Why heart disease mortality is
low in France: the time lag explanation. BMJ, 318, 1471-80.
Leon DA, Chenet L, Shkolnikov VM. (1998) Huge variation
in Russian mortality rates 1984-94: artefact, alcohol, or what? Lancet, 350, 383-88.
Marmot MG. (1984) Alcohol and coronary heart disease.
Int J Epidemiol 13, 160-67.
Marmot MG. (2001) Commentary: reflection on alcohol
and coronary heart disease. Int J Epidemiol, 30, 729-34.
Marmot MG, Brunned E. (1991) Alcohol and cardiovascular
disease: the status of the U-shaped curve. BMJ, 303, 565-68.
Marmot MG, Rose G, Shipley MJ, Thomas BJ (1981) Alcohol and mortality: a U-shaped curve. Lancet, 1, 580-83.
Martyn C. (2000) Hebdomadal rhythms of the heart. BMJ, 321, 1542-43.
McKee M, Britton A. (1998) The positive relationship between alcohol and heart disease in Eastern Europe: potential physiological mechanisms. J R Soc Med, 91, 402-407.
Metsanen H. (1990) Arrhythmias and alcohol abuse in
working-aged men. Pharmacol Toxicol, 67, 2-10.
Muntwyler J, Bennekers CH, Buring JE, Graziano JM. (1998) Mortality and light moderate alcohol consumption after myocardial infarction. Lancet., 352, 1882-85.
Notzon F, Komarov YM, Ermakov SP, Sempos C, Marks JS. (1998) Causes of declining life expectancy in Russia. J American Med Assoc, 279, 793-800.
Palomaki H, Kaste M. (1993) Regular light-to-moderate
intake of alcohol and the risk of ischemic stroke. Is there a beneficial effect? Stroke, 24, 1828-32.
Razvodovsky YE. (2000) Structure and dynamics of Alcohol-related Mortality in Belarus. Alcoholism, 36, 109-120.
Renaud S, De Lorgeril M. (1992) Wine, alcohol, platelets
and the French paradox. Lancet, 339, 1523-26.
Rimm EB, Klatsky A, Grobber P, Stampfer MJ. (1996) Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits? BMJ, 312, 731-36.
Rimm EB, Klatsky A, Grobblee D, Stampfer J. (1996) Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine or spirits? BMJ 312: 731-736.
Rotondo S. (2001) The relationship between wine consumption and cardiovascular risk: from epidemiological evidence to biological plausibility. Ital Heart J, 2, 1-8.
Salonen JT, Puska P, Nissinen A. (1983) Intake of spirits
and beer and risk of myocardial infarction and death – a longitudinal study in eastern Finland. J Chronic Diseases, 36, 533-43.
Sasaki S. (2000) Alcohol and its relation to all-cause and
cardiovascular mortality. Acta Cardiol 55 :151-156.
Stampfer MJ, Colditz GA, Willett WC, Speizer FE, Hennekens CH. (1988) A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N Engl J Med, 319, 267-73.
Stefanini GF, Caputo F, Addolorato G. (1998) J-shaped
curve: moderation is a fundamental requisite also in the interpretation and use of results. Alcologia: Eur J Alcohol Study, 10, 83-84.
Thornton J, Symes C, Heaton K. (1983) Moderate alcohol
intake reduces bile cholesterol saturation and raises HDL cholesterol. Lancet, 348, 819-22.
Turnet Ch, Anderson P. (1990) Alcohol and cardiovascular
disease: what is the relationship. Br J Addiction, 85, 851-853.
Vikhert A. (1986) Alcoholic cardiomyopathy and sudden
cardiac death. J. Amer. Coll. Cardiol. 8(1): 3-11.
Yano K, Phoads GG, Kagan A. (1977) Coffee, alcohol and
risk of coronary heart disease among Japanese men living in Hawaii. N Engl J Med, 297, 405-9.