Alcohol and its relation to all-cause and cardiovascular mortality

There exists a considerable body of evidence indicating that light-to-moderate alcohol consumption is associated with a reduced mortality from ischaemic heart disease (IHD). However, an L-shaped saturation curve has been observed in many prospective studies on alcohol consumption and IHD mortality. No further risk reduction is expected if more than 30 grams of ethanol per day is consumed. In ecological studies, particularly wine showed a strongly negative correlation with IHD mortality. This possible specific effect of wine has not yet been confirmed in observational prospective studies. The evidence found in the ecological studies may partly be explained by several healthy dietary habits associated with wine drinking. Although the results of the prospective studies are less consistent for stroke mortality, the largest risk reduction was observed among the drinkers with 10-20 grams of ethanol per day, and then the risk increased. However as an opposite effect of alcohol is expected to ischaemic and haemorrhagic stroke, further studies with consideration to the type of stroke are needed. Several prospective studies demonstrated a J-shaped curve between alcohol consumption and all-cause mortality both in men and women. It is usually explained by a risk reduction of mortality from IHD and stroke among light drinkers. Considering that the risk reduction for all-cause mortality is limited in light-to-moderate drinkers and the reduction is small and that heavy alcohol consumption has an apparently harmful effect, a general increase in alcohol consumption at the population level is not recommended.