Current Atherosclerosis Reports

, Volume 2, Issue 6, pp 529–535 | Cite as

Alcohol and cardiovascular disease

  • Eric Rimm


Alcohol in moderation is associated with lower risk of coronary heart disease in healthy men and women. New evidence suggests that this association, described in over 70 epidemiologic studies, is causal and can be explained, in part, by alcohol’s beneficial effects on serum lipids and clotting factors. Recently, the inverse association between alcohol and cardiovascular disease also has been reported in populations with adult-onset diabetes and among individuals with previous cardiovascular disease. Although mounting evidence strongly supports the cardiovascular benefits of moderate alcohol consumption in most populations, clinical advice to abstainers to initiate daily alcohol consumption has not yet been substantiated in the literature and must be taken with caution and given on an individual basis.


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References and Recommended Reading

  1. 1.
    Klatsky AL, Friedman GD, Siegelaub AB: Alcohol consumption before myocardial infarction. Results from the Kaiser-Permanente epidemiologic study of myocardial infarction. Ann Intern Med 1974, 81:294–301.PubMedGoogle Scholar
  2. 2.
    Klatsky AL, Armstrong MA, Friedman GD: Risk of cardiovascular mortality in alcohol drinkers, ex-drinkers, and nondrinkers. Am J Cardiol 1990, 66:1237–1242.PubMedCrossRefGoogle Scholar
  3. 3.
    Klatsky AL, Armstrong MA, Friedman GD: Red wine, white wine, liquor, beer, and risk of coronary artery disease hospitalization. Am J Cardiol 1997, 80:416–420.PubMedCrossRefGoogle Scholar
  4. 4.
    Grobbee DE, Rimm EB, Keil U, Renaud S: Alcohol and the Cardiovascular System. In Health Issues Related to Alcohol Consumption, edn 2. Edited by MacDonald I. Oxford: Blackwell Science Ltd, 1999:125–179.Google Scholar
  5. 5.
    US Department of Agriculture, US Department of Health and Human Services. Nutrition and Your Health: Dietary Guidelines for Americans, edn 5. Washington, DC: U. S. Government Printing Office; 2000.Google Scholar
  6. 6.
    Inter-Departmental Working Group: Sensible Drinking. Wetherby, U.K.: Department of Health; 1995.Google Scholar
  7. 7.
    Rimm EB, Klatsky A, Grobbee D, Stampfer MJ: Review of moderate alcohol consumpton and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits? BMJ 1996, 312:731–736.PubMedGoogle Scholar
  8. 8.
    Wannamethee SG, Shaper AG: Type of alcoholic drink and risk of major coronary heart disease events and all-cause mortality. Am J Public Health 1999, 89:685–690.PubMedCrossRefGoogle Scholar
  9. 9.
    Klatsky AL, Armstrong MA, Kipp H: Correlates of alcoholic beverage preference: traits of persons who choose wine, liquor or beer. Br J Addict 1990, 85:1279–1289.PubMedCrossRefGoogle Scholar
  10. 10.
    Rimm EB, Giovannucci EL, Willett WC, et al.: Prospective study of alcohol consumption and risk of coronary disease in men. Lancet 1991, 338:464–468.PubMedCrossRefGoogle Scholar
  11. 11.
    Kozarevic D, Demirovic J, Gordon T, et al.: Drinking habits and coronary heart diease: the Yugoslavia Cardiovascular Disease Study. Am J Epidemiol 1982, 116:748–758.PubMedGoogle Scholar
  12. 12.
    Renaud SC, Guéguen R, Siest G, Salamon R: Wine, beer, and mortality in middle-aged men from Eastern France. Arch Intern Med 1999, 159:1865–1870.PubMedCrossRefGoogle Scholar
  13. 13.
    Yuan J, Ross RK, Gao Y, et al.: Follow-up study of moderate alcohol intake and mortality among middle aged men in Shanghai, China. BMJ 1997, 314:18–23.PubMedGoogle Scholar
  14. 14.
    Tsugane S, Fahey MT, Sasaki S, et al.: Alcohol consumption and all-cause and cancer mortality among middle-aged men: seven-year follow-up of the JPHC Study Cohort I. Am J Epidemiol 1999, 150:1201–1207.PubMedGoogle Scholar
  15. 15.
    Kagan A, Yano K, Rhoads GG, McGee DL: Alcohol and cardiovascular disease: the Hawaiian experience. Circulation 1981, 64:27–31.Google Scholar
  16. 16.
    Wannamethee SG, Shaper AG: Alcohol, coronary heart disease and stroke: an examination of the J-shaped curve. Neuroepidemiology 1998, 17:288–295.PubMedCrossRefGoogle Scholar
  17. 17.
    Rimm EB, Williams P, Fosher K, et al.: A biologic basis for moderate alcohol consumption and lower coronary heart disease risk: a meta-analysis of effects on lipids and hemostatic factors. BMJ 1999, 319:1523–1528.PubMedGoogle Scholar
  18. 18.
    Criqui MH, Cowan LD, Tyroler HA, et al.: Lipoproteins as mediators for the effects of alcohol consumption and cigarette smoking on cardiovascular mortality: results from the Lipid Research Clinics Follow-up study. Am J Epidemiol 1987, 126:629–637.PubMedGoogle Scholar
  19. 19.
    Langer RD, Criqui MH, Reed DM: Lipoproteins and blood pressure as biological pathways for effect of moderate alcohol consumption on coronary heart disease. Circulation 1992, 85:910–915.PubMedGoogle Scholar
  20. 20.
    Leppälä JM, Paunio M, Virtamo J, et al.: Alcohol consumption and stroke incidence in male smokers. Circulation 1999, 100:1209–1214.PubMedGoogle Scholar
  21. 21.
    Stampfer MJ, Sacks FM, Salvini S, et al.: A prospective study of cholesterol, apolipoproteins, and the risk of myocardial infarction. N Engl J Med 1991, 325:373–381.PubMedCrossRefGoogle Scholar
  22. 22.
    Jacobs DR, Jr., Mebane IL, Bangdiwala SI, et al.: High density lipoprotein cholesterol as a predictor of cardiovascular disease mortalilty in men and women: the follow-up study of the Lipid Research Clinics Prevalence Study. Am J Epidemoil 1990, 131:32–47.Google Scholar
  23. 23.
    Rimm EB, Chan J, Stampfer MJ, et al.: Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ 1995, 310:555–559.PubMedGoogle Scholar
  24. 24.
    Stampfer MJ, Colditz GA, Willett WC, et al.: A prospective study of moderate alcohol drinking and risk of diabetes in women. Am J Epidemiol 1988, 128:549–558.PubMedGoogle Scholar
  25. 25.
    Perry E, Wannamethee SG, Walker MK, et al.: Prospective study of risk factors for development of non-insulin dependent diabetes in middle-aged British men. BMJ 1995, 310:560–564.PubMedGoogle Scholar
  26. 26.
    Tsumura K, Kayashi T, Suematsu C, et al.: Daily alcohol consumption and the risk of type 2 diabetes in Japanese men: the Osaka Health Survey. Diabetes Care 1999, 22:1432–1437.PubMedCrossRefGoogle Scholar
  27. 27.
    Kiechl S, Willeit J, Poewe W, et al.: Insulin sensitivity and regular alcohol consumption: large, prospective, cross sectional population study (Bruneck study). BMJ 1996, 313:1040–1044.PubMedGoogle Scholar
  28. 28.
    Lazarus S, Sparrow D, Weiss S: Alcohol intake and insulin levels: the Normative Aging Study. Am J Epidemiol 1997, 145:909–916.PubMedGoogle Scholar
  29. 29.
    Razay G, Heaton KW: Alcohol consumption and cardiovascular risk factors in middle-aged men. Cardiovascular Risk Factors 1995, 5:200–205.Google Scholar
  30. 30.
    Flanagan DEH, Moore VM, Godsland IF, et al.: Alcohol consumption and insulin resistance in young adults. Eur J Clin Invest 2000, 30:297–301.PubMedCrossRefGoogle Scholar
  31. 31.
    St. Leger AG, Cochrane AL, Moore F: Factors associated with cardiac mortality in developed countries with particular reference to the consumption of wine. Lancet 1979, 1:1017–1020.PubMedCrossRefGoogle Scholar
  32. 32.
    Bell JR, Donovan JL, Wong R, et al.: (+)-Catechin in human plasma after ingestion of a single serving of reconstituted red wine. Am J Clin Nutr 2000, 71:103–108.PubMedGoogle Scholar
  33. 33.
    Renaud SC, Ruf JC: Effects of alcohol on platelet functions. Clin Chimica Acta 1996, 246:77–89.CrossRefGoogle Scholar
  34. 34.
    Kitamura A, Iso H, Sankai T, et al.: Alcohol intake and premature coronary heart disease in urban Japanese men. Am J Epidemiol 1998, 147:59–65.PubMedGoogle Scholar
  35. 35.
    Rehm JT, Bondy SJ, Sempos CT, Vuong CV: Alcohol consumption and coronary heart disease morbidity and mortality. Am J Epidemiol 1997, 146:495–501.PubMedGoogle Scholar
  36. 36.
    Puddey IB, Rakic V, Dimmitt SG, Beilin LJ: Influence of pattern of drinking on cardiovascular disease and cardiovascular risk factors—a review. Addiction 1999, 94:649–663.PubMedCrossRefGoogle Scholar
  37. 37.
    Suhonen O, Aromas A, Reunanen A, Knekt P: Alcohol consumption and sudden coronary death in middle-aged Finnish men. Acta Med Scand 1987, 221:335–341.PubMedCrossRefGoogle Scholar
  38. 38.
    Kauhanen J, Kaplan GA, Goldberg DE, Salonen JT: Beer binging and mortality: results from the Kuopio ischaemic heart disease risk factor study, a prospective population based study. BMJ 1997, 315:846–851.PubMedGoogle Scholar
  39. 39.
    McElduff P, Dobson AJ: How much alcohol and how often? Population-based case-control study of alcohol consumption and risk of a major coronary event. BMJ 1997, 314:1159–1164.PubMedGoogle Scholar
  40. 40.
    Rakic V, Puddey IB, Dimmitt SB, et al.: A controlled trial of effects of pattern of alcohol intake on serum lipid levels in regular drinkers. Atherosclerosis 1998, 137:243–252.PubMedCrossRefGoogle Scholar
  41. 41.
    van Tol A, van der Gaag MS, Scheek LM, et al.: Changes in postprandial lipoproteins of low and high density caused by moderate alcohol consumption with dinner. Atherosclerosis 1998, 141:S101-S103.PubMedCrossRefGoogle Scholar
  42. 42.
    Rumpler WV, Clevidence BA, Muesing RA, Rhodes DG: Changes in women’s plasma lipid and lipoprotein concentrations due to moderate consumption of alcohol are affected by dietary fat level. J Nutr 1999, 129:1713–1717.PubMedGoogle Scholar
  43. 43.
    Stampfer MJ, Colditz GA, Willett WC, et al.: A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N Engl J Med 1988, 319:267–273.PubMedCrossRefGoogle Scholar
  44. 44.
    Sacco RL, Elkind M, Boden-Albala B, et al.: The protective effect of moderate alcohol consumption on ischemic stroke. JAMA 1999, 281:53–60.PubMedCrossRefGoogle Scholar
  45. 45.
    Berger K, Ajani UA, Kase CS, et al.: Light-to-moderate alcohol consumption and the risk of stroke among US male physicians. N Engl J Med 1999, 341:1557–1564.PubMedCrossRefGoogle Scholar
  46. 46.
    Kiechl S, Willeit J, Rungger G, et al.: Alcohol consumption and atherosclerosis: What is the relation? Prospective results from the Bruneck study. Stroke 1998, 29:900–907.PubMedGoogle Scholar
  47. 47.
    Thrift AG, Donnan GA, McNeil JJ: Heavy drinking, but not moderate or intermediate drinking, increases the risk of intracerebral hemorrhage. Epidemiology 1999, 10:307–312.PubMedCrossRefGoogle Scholar
  48. 48.
    Smith-Warner SA, Spiegelman D, Yaun S-S, et al.: Alcohol and breast cancer in women: a pooled analysis of cohort studies. JAMA 1998, 279:535–540.PubMedCrossRefGoogle Scholar
  49. 49.
    Thun MJ, Peto R, Lopez AD, et al.: Alcohol consumption and mortality among middle-aged and elderly US adults. N Eng J Med 1997, 337:1705–1714.CrossRefGoogle Scholar
  50. 50.
    Fuchs CS, Stampfer MJ, Colditz GA, et al.: Alcohol consumption and mortality among women. N Engl J Med 1995, 332:1245–1250.PubMedCrossRefGoogle Scholar
  51. 51.
    Hart CL, Smith GD, Hole DJ, Hawthorne VM: Alcohol consumption and mortality from all causes, coronary heart dsease, and stroke: results from a prospective cohort study of Scottish men with 21 years of follow-up. BMJ 1999, 318:1725–1729.PubMedGoogle Scholar
  52. 52.
    Camargo CA, Jr, Rimm EB: Epidemiologic research on moderate alcohol consumption and blood pressure. In Alcohol and Cardiovascular System. Research Monograph 31. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism, NIH Publication No. 96-4133, 1996:25–62.Google Scholar
  53. 53.
    Valmadrid CT, Klein R, Moss SE, et al.: Alcohol intake and the risk of coronary heart disease mortality in persons with older-onset diabetes mellitus. JAMA 1999, 282:239–246.PubMedCrossRefGoogle Scholar
  54. 54.
    Solomon CG, Hu FB, Stampfer MJ, et al.: Moderate alcohol consumption and risk of coronary heart disease among women with type 2 diabetes mellitus. Circulation 2000, 102:494–499.PubMedGoogle Scholar
  55. 55.
    Muntwyler J, Hennekens CH, Buring JE, Gaziano JM: Mortality and light to moderate alcohol consumption after myocardial infarction. Lancet 1998, 352:1882–1885.PubMedCrossRefGoogle Scholar
  56. 56.
    G SA, Wannamethee SG: Alcohol intake and mortality in middle aged men with diagosed coronary heart disease. Heart 2000, 83:394–399.CrossRefGoogle Scholar

Copyright information

© Current Science Inc 2000

Authors and Affiliations

  • Eric Rimm
    • 1
  1. 1.Department of NutritionHarvard School of Public HealthBostonUSA

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