Recent Issues in Alcohol Drinking and Cardiovascular Disease

Abstract

Light-to-moderate alcohol drinking reduces the risk of atherosclerotic diseases such as coronary heart disease, ischemic-type stroke, and peripheral artery disease through the anti-atherosclerotic and anti-thrombotic effects of alcohol. These beneficial effects of alcohol are explained mainly by its blood lipid-improving actions, such as hDL cholesterol-increasing and LDL cholesterol-decreasing actions, and by its blood coagulation-suppressing actions, such as platelet aggregation-inhibiting, blood fibrinogen-decreasing, and plasminogen activator-increasing actions. These biological actions of alcohol are thought to be independent of the type of beverage and to be due to ethanol itself. On the other hand, excessive drinking and binge drinking increase the risk of hypertension, hemorrhagic-type stroke, arrhythmia, and cardiomyopathy. The guidelines of the international and Japanese societies of hypertension recommend that alcohol intake should be restricted to less than two drinks (24 g ethanol) per day in men and one drink (12 g ethanol) per day in women. Alcohol drinking should never be recommended for promotion of health in those who are currently nondrinkers since there is no way of predicting the future likelihood of excessive drinking and addiction. Moreover, individual background factors such as age, gender, body weight, history of smoking, history of hypertension therapy, and polymorphism of alcohol-metabolizing enzymes should be taken into account when considering alcohol intake volume suitable for each individual. The etiology of alcohol-induced hypertension and cardiomyopathy remains to be clarified. Future studies are also needed to determine whether light-tomoderate alcohol drinking is permissible in persons with atherosclerotic disease and in persons with risk factors for atherosclerosis.