Alcohol and cardiovascular health: the razor-sharp double-edged sword.
An extensive body of data shows concordant J-shaped associations between alcohol intake and a variety of adverse health outcomes, including coronary heart disease, diabetes, hypertension, congestive heart failure, stroke, dementia, Raynaud's phenomenon, and all-cause mortality. Light to moderate alcohol consumption (up to 1 drink daily for women and 1 or 2 drinks daily for men) is associated with cardioprotective benefits, whereas increasingly excessive consumption results in proportional worsening of outcomes. Alcohol consumption confers cardiovascular protection predominately through improvements in insulin sensitivity and high-density lipoprotein cholesterol. The ethanol itself, rather than specific components of various alcoholic beverages, appears to be the major factor in conferring health benefits. Low-dose daily alcohol is associated with better health than less frequent consumption. Binge drinking, even among otherwise light drinkers, increases cardiovascular events and mortality. Alcohol should not be universally prescribed for health enhancement to nondrinking individuals owing to the lack of randomized outcome data and the potential for problem drinking.
O'Keefe
James H
JH
Mid America Heart Institute, University of Missouri, Kansas City, Missouri, USA. jhokeefe@cc-pc.com
Bybee
Kevin A
KA
Lavie
Carl J
CJ
D000428:Alcohol Drinking / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control*; D002319:Cardiovascular System / Q000187:drug effects; D002492:Central Nervous System Depressants / Q000494:pharmacology; D000431:Ethanol / Q000494:pharmacology; D044882:Glucose Metabolism Disorders / Q000517:prevention & control; D006801:Humans; D018570:Risk Assessment