Alcohol consumption and coronary heart disease

Previous research suggests an inverse relation between moderate alcohol consumption and coronary heart disease. The benefit of mild to moderate alcohol intake seems to be more pronounced in people with a history of myocardial infarction. Numerous studies have shown among diabetic patients (male and female) that moderate alcohol consumption (less than two drinks per day or less than 30 grams per day) decreased the risk of coronary heart disease (Tanasescu, J Am Coll Cardiol 2001; 38:1836-42; Fuchs, N Engl J Med 1995; 332: 1245-50). When the alcohol intake exceed two drinks (or 30 grams per day) total mortality is increased by non cardiovascular mortality (cancers of oropharynx and esophagus for men and breast cancer for women). The mechanisms underlying the association are still discussed (increase of HDL-C, inhibition of platelet aggregation, decrease of the production of oxidize lipoprotein, increased insulin sensitivity). The major hazards of alcohol intake in diabetic patient are hypoglycemia and acidosis but the same other side effects of alcohol are observed in diabetic and non diabetic patients. Since the diabetic patient has an especially high risk of coronary heart disease, the use of a moderate amount of alcohol should not be discouraged.