Alcohol and Cardiovascular Health: The Dose Makes the Poison…or the Remedy

Abstract

Habitual light to moderate alcohol intake (up to 1 drink per day for women and 1 or 2 drinks per day for men) is associated with decreased risks for total mortality, coronary artery disease, diabetes mellitus, congestive heart failure, and stroke. However, higher levels of alcohol consumption are associated with increased cardiovascular risk. Indeed, behind only smoking and obesity, excessive alcohol consumption is the third leading cause of premature death in the United States. Heavy alcohol use (1) is one of the most common causes of reversible hypertension, (2) accounts for about one-third of all cases of nonischemic dilated cardiomyopathy, (3) is a frequent cause of atrial fibrillation, and (4) markedly increases risks of stroke-both ischemic and hemorrhagic. The risk-to-benefit ratio of drinking appears higher in younger individuals, who also have higher rates of excessive or binge drinking and more frequently have adverse consequences of acute intoxication (for example, accidents, violence, and social strife). In fact, among males aged 15 to 59 years, alcohol abuse is the leading risk factor for premature death. Of the various drinking patterns, daily low- to moderate-dose alcohol intake, ideally red wine before or during the evening meal, is associated with the strongest reduction in adverse cardiovascular outcomes. Health care professionals should not recommend alcohol to nondrinkers because of the paucity of randomized outcome data and the potential for problem drinking even among individuals at apparently low risk. The findings in this review were based on a literature search of PubMed for the 15-year period 1997 through 2012 using the search terms alcohol, ethanol, cardiovascular disease, coronary artery disease, heart failure, hypertension, stroke, and mortality. Studies were considered if they were deemed to be of high quality, objective, and methodologically sound.

Moderate Alcohol Consumption Is Associated With Left Ventricular Diastolic Dysfunction in Nonalcoholic Hypertensive Patients

“…13 It is well known that alcohol abuse is associated with increased prevalence of hypertension 30 and progressive impairment of LV systolic function, leading to dilated cardiomyopathy and congestive heart failure. 31 Previous studies conducted with conventional echocardiographic technique reported also an association between ethanol consumption and impaired LV diastolic properties in asymptomatic chronic alcoholics. 14,15,32 However, information on the effects of moderate ethanol consumption on LV diastolic filling is limited.…”

Alcohol drinking pattern and total cardiovascular risk in able-bodied people

“…[7] было по-казано, что предпочтение потребления пива (умеренное) сопровождается снижением кардиоваскулярного риска, хотя и в меньшей степени, чем предпочтение потребления вина. В то же время ряд исследователей [5,[10][11][12][13] выска-зывают предположение, что кардиопротективными свой-ствами обладает исключительно красное вино либо в силу своего химического состава, либо в силу того, что умерен-ное регулярное потребление красного вина характерно для стран или лиц, соблюдающих более здоровую диету по типу средиземноморской. В метаанализе, проведенном M. Roerecke и J. Rehm [14], сделан вывод, что протективная роль умеренного и низкого потребления алкоголя не может быть признана без проведения дополнительных исследований из-за существенной гетерогенности проведенных работ.…”

“…Кроме этого, имеются сведе-ния, что предпочтение потребления того или иного типа алкогольного напитка связано с социальными фактора-ми, такими как возраст, уровень образования и доходов [15], т.е. причиной может быть не протективное действие алкоголя как такового (что, кстати, отвергают ряд иссле-дователей [13]), а особенности стиля жизни обследован-ных либо химическим составом предпочитаемого напитка [5,[11][12][13].…”

“…В ряде исследований, обзорах и обобщающих мета-анализах описано протективное (кардиопротективное) действие умеренного (в низких дозах) регулярного потреб-ления алкоголя [5,[7][8][9][10][11][12][13], который исчезает, если случа-ются случаи чрезмерного (опасного, тяжелого) потребле-ния: 3-6 раз в год не менее 3 алкогольных единиц (АЕ) для женщин, не менее 5 -для мужчин [3,5,14].…”

Low glycemic index diet reduces body fat and attenuates inflammatory and metabolic responses in patients with type 2 diabetes

“…Eligible participants were men or premenopausal women between 18 and 55 years old with type 2 diabetes who were receiving biguanides therapy (metformin), which did not change their medications in the previous three months and who had body fat percentage values higher than 16% for men and 24% for women. The exclusion criteria were tobacco use, consumption of > 50 g/day of alcohol (14), pregnancy or lactation, menopause or postmenopause, regular use of hormones, antiinflammatory medications or other medications that might interfere with outcome measures, recent change (in the previous three months) in the level of physical activity (15) or diet, weight instability (> 3 kg in the previous three months), on a therapeutic diet, dietary allergies or intolerances, cancer, or cardiovascular, renal, or liver disease. Of 102 individuals interested to participate in the study, 55 met the inclusion criteria in the initial screening (via telephone).…”