title: Alcohol and Cardiovascular Disease: How Much is Too Much?
abstract: OBJECTIVE
  Previous research suggests that low-moderate alcohol consumption may have cardioprotective effects, while heavy or binge-pattern drinking is harmful. New evidence and research methodology may inform safe thresholds of alcohol use. This review examines recent evidence regarding alcohol's effect on cardiovascular disease, with a special consideration of pattern, drink type, and total quantity.
  
  
  RESULTS
  New epidemiologic research confirms the potential harmful cardiovascular effects of heavy episodic alcohol use and does not support the previous observation that low-moderate alcohol use protects against stroke. Alcohol consumption also appears to have a continuous positive relationship with the risk of atrial fibrillation. In addition, Mendelian randomization analyses suggest that alcohol may have a direct causal role in adverse cardiovascular effects. Recent studies have confirmed that heavy alcohol use (>14 drinks per week in women and >21 drinks per week in men) and heavy episodic drinking are associated with an increased risk of mortality. New research raises concerns that even low-moderate alcohol use may not offer cardio- or cerebrovascular protection. Drinking ≥3 drinks per day on a regular basis or ≥5 drinks in any one episode should be discouraged.
authors.affiliation: McMaster University, Hamilton, ON, Canada.
authors.forename: Augustin
authors.initials: A
authors.lastname: Toma
authors.affiliation: The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Paré
authors.affiliation: McMaster University, Hamilton, ON, Canada. leongd@phri.ca.|The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada. leongd@phri.ca.|C3-106 David Braley Building, Hamilton General Hospital, 237 Barton St. East, Hamilton, ON, Canada, L8L 2X2. leongd@phri.ca.
authors.forename: Darryl P
authors.initials: DP
authors.lastname: Leong
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D006801:Humans; D012307:Risk Factors; D018433:Twin Studies as Topic
keywords: Alcohol; Alcohol consumption; CVD; Cardiovascular disease; Drinking