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British Medical Journal

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Clinical Articles, Lead Article

Cardiovascular benefits of moderate alcohol drinking

Drinking alcohol in moderation protects against cardiovascular (CV) disease, according to a recent systematic review and meta-analysis of interventional studies.

Individuals who drink alcohol in moderation (about one drink a day or less) are 14-25% less likely to suffer CV disease compared to those who drink no alcohol at all, finds research led by Professor William Ghali from the University of Calgary, published recently on bmj.com.

A study(1) led by Paul Ronksley from the University of Calgary analysed 84 prospective cohort studies on the association between alcohol consumption and overall mortality from CV disease, incidence of and mortality from coronary heart disease, and incidence of and mortality from stroke. Dose-response analysis revealed that the lowest risk of coronary heart disease mortality occurred with 1–2 drinks a day, with a lower risk for drinkers compared with non-drinkers (relative risk 0.87 (0.83 to 0.92)).

alcohol-2An accompanying paper(2) led by Dr Susan Brien, also from the University of Calgary, found that favourable changes in several CV biomarkers (higher levels of high density lipoprotein cholesterol and adiponectin and lower levels of fibrinogen) provide indirect pathophysiological support for a protective effect of moderate alcohol use on coronary heart disease. The review analysed 63 studies that examined adults without known cardiovascular disease and that compared fasting levels of specific biological markers associated with coronary heart disease after alcohol use with those after a period of no alcohol use.

Moderate amounts of alcohol significantly increase the levels of ‘good’ cholesterol circulating in the body and this has a protective effect against heart disease, both studies claim.

The authors acknowledge that a number of previous studies have concluded that moderate alcohol consumption has been associated with a decrease in heart disease. However, they say that the research was out-of-date and there was a need for new material. Professor Ghali says his team’s research is the most comprehensive to date.

Brien’s research also assessed the impact of the type of alcohol consumed (wine, beer or spirits), concluding that it is the alcohol content that provides the health benefits not the type of alcoholic beverage that is drunk.

Professor Ghali concludes that “with respect to public health messages there may now be an impetus to better communicate to the public that alcohol, in moderation, may have overall health benefits that outweigh the risks in selected subsets of patients … any such strategy would need to be accompanied by rigorous study and oversight of impacts”.

References

  1. Ronksley PE, Brien SE, Turner BJ et al. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ 2011;342:d671 doi:10.1136/bmj.d671
    Available online: http://www.bmj.com/cgi/doi/10.1136/bmj.d671
  2. Brien SE, Ronksley PE, Turner BJ. Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ 2011;342:d636 doi: 10.1136/bmj.d636
    Available online: http://www.bmj.com/content/342/bmj.d636

Published on: March 3, 2011

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