Moderate alcohol consumption and coronary heart disease: a review.

Consumption of alcoholic beverages has been a prominent feature of many cultures since the ancient civilisations. Throughout history, the pros and cons of alcohol have been debated. Although the original debates stemmed from the public perception of intoxication, current research has convincingly demonstrated the permanent physiological damage due to prolonged overconsumption. However, the eVect of “moderate” alcohol consumption on overall health remains controversial. The beneficial eVects of alcohol on the cardiovascular system have been touted since the 18th century, but the bulk of scientific research has accumulated over the last few decades. The majority of the literature suggests that alcohol in moderation is beneficial on the cardiovascular system, and excess is detrimental to overall health. The deleterious eVects of heavy alcohol consumption on health are numerous: aerodigestive cancers; haemorrhagic stroke and cardiomyopathy; hepatic cirrhosis; fetal alcohol syndrome; fatal car crashes, and suicides. However, these eVects have not been documented among light to moderate drinkers. Although the risks substantially outweigh the benefits for heavy consumption, the burden of coronary heart disease (CHD) has tipped the scale in favour of moderate alcohol consumption for overall health. In the US and many westernised countries, CHD is the leading cause of mortality. It has been estimated that if moderate alcohol consumption lowered risk by even 25%, more deaths could hypothetically be prevented than caused by this exposure in westernised countries. However, the concern that promoting moderate alcohol consumption may lead to alcohol abuse among certain “at risk” individuals has muted the avocation of moderate alcohol consumption for health reasons.