International Circulation : We just talked about alcohol and what about atrial fibrillation risk with alcohol?  Will even a small amount increase risk and cause problems?

　　《国际循环》：我们刚才谈到了饮酒，饮酒对心房颤动发生风险有何影响？少量饮酒是否会增加心房颤动风险并导致问题？

　　James O’Keefe : For most things， alcohol is a J shaped curve so that with teetotalers， one or 2 drinks per day will reduce all cause of mortality; heart attacks， stroke， diabetes risk， but by 3 or 4 you are getting back to teetotaler， by 5 or 6 or 7 you get this very high risk.  With atrial fibrillation it is really not j shaped.  You can get by with maybe one drink of alcohol without any increased risk of atrial fibrillation.  After that it is a step wise increase that is dose dependent increased risk of atrial fibrillation.  By the time you are drinking 3 drinks a day your risk is increased and by 10 drinks a day your risk of atrial fibrillation is doubled.  By the way hypertension is the same in that regard.  One drink a day will probably reduce risk of blood pressure a little bit.  By 2 you are back to teetotalers， by 3， 4， or 5 drinks， well it is dose dependent so the most common cause of reversible hypertension in America and probably in China and Japan as well would be access alcohol consumption.  You get that alcohol intake， you stop that alcohol intake and that blood pressure comes down dramatically over time.  Excess alcohol contributes to about 1/3 of the cases of non ischemic cardiomyopathy， it is a very common cause of non ischemic cardiomyopathy.  Again， it looks like there you can get by with one or 2 per day.  After that there is an increased risk and there is a lot of potential downsides of excess alcohol that counterbalance the potential benefit of light to moderate alcohol intake.

　　James O’Keefe教授：饮酒量与大多数疾病的相关性呈J型曲线，每天饮用1或两标准杯会降低全因死亡率、心脏病、卒中及糖尿病发生风险；饮用三或四杯时上述风险与不饮酒者相当，饮用5~7杯则显著增加上述风险。但是，饮酒与心房颤动的相关性则并不呈J型曲线。可能饮用一杯时并不增加心房颤动发生风险，但饮用一杯以上时随着饮酒量的增加心房颤动风险会显著增加。每天饮酒三杯时心房颤动风险显著增加，饮用10杯时心房颤动发生风险可加倍。这同高血压与饮酒的关系一样。每天饮用一杯酒可能会轻度降低高血压发生风险，饮用两倍时则和不饮酒者相同，饮用3~5杯时增加高血压发生风险。因此，在美国、中国、日本，高血压最常见的可逆性病因都是过量饮酒。停止饮酒后，随着时间的推移患者的血压会显著降低。过量饮酒是非缺血性心肌病的常见病因，有三分之一的非缺血性心肌病可归因于过量饮酒。可能每天饮用1或两杯没有问题，但应用2杯以上时其风险就会显著增加。与少量/适量饮酒而言，过量饮酒的潜在风险大于获益。