Search resultsTo drink or not to drink? That is the question
Title
To drink or not to drink? That is the question
Publication type
Journal Article
Year of Publication
2007
Authors
Journal
Circulation
Volume
116
Issue
11
Pagination
1306 - 1317
Date published
2007
ISBN
00097322 (ISSN)
Keywords
alcohol, alcohol consumption, Alcohol Drinking, Alcoholic Beverages, alcoholic cardiomyopathy, angina pectoris, antioxidant activity, Arrhythmia, brain hemorrhage, cancer, Cardiomyopathy, Cardiovascular Diseases, congestive heart failure, coronary artery disease, fibrinogen, fibrinogen blood level, fibrinolysis, heart arrhythmia, heart death, heart failure, heart infarction, heart protection, high density lipoprotein cholesterol, human, Humans, hypertension, inflammation, mortality, Myocardial Infarction, Plasma viscosity, priority journal, review, Risk Factors, stroke, sudden death, thrombocyte aggregation, vascular endothelium, wine
Abstract
Numerous studies have used a J-shaped or U-shaped curve to describe the relationship between alcohol use and total mortality. The nadir of the curves based on recent meta-analysis suggested optimal benefit at approximately half a drink per day. Fewer than 4 drinks per day in men and fewer than 2 per day in women appeared to confer benefit. Reductions in cardiovascular death and nonfatal myocardial infarction were also associated with light to moderate alcohol intake. Although some studies suggested that wine had an advantage over other types of alcoholic beverages, other studies suggested that the type of drink was not important. Heavy drinking was associated with an increase in mortality, hypertension, alcoholic cardiomyopathy, cancer, and cerebrovascular events, including cerebrovascular hemorrhage. Paradoxically, light-to-moderate alcohol use actually reduced the development of heart failure and did not appear to exacerbate it in most patients who had underlying heart failure. Numerous mechanisms have been proposed to explain the benefit that light-to-moderate alcohol intake has on the heart, including an increase of high-density lipoprotein cholesterol, reduction in plasma viscosity and fibrinogen concentration, increase in fibrinolysis, decrease in platelet aggregation, improvement in endothelial function, reduction of inflammation, and promotion of antioxidant effects. Controversy exists on whether alcohol has a direct cardioprotective effect on ischemic myocardium. Studies from our laboratory do not support the concept that alcohol has a direct cardioprotective effect on ischemic/reperfused myocardium. Perhaps the time has come for a prospectively randomized trial to determine whether 1 drink per day (or perhaps 1 drink every other day) reduces mortality and major cardiovascular events.