What we know about role of alcohol in prevention of cardiovascular diseases? Anno Domini 2010

According to many epidemiological studies the relation between alcohol and total mortality can be describe by U-curve. In some population this relationship can by, however, represented by J-curve. In those who drink moderate quantity of alcohol (1-2 drinks per day) the reduction of the global cardiovascular risk has been shown, mostly due to the decreased number of angina, ischemic cerebral stroke and symptomatic peripheral arteriosclerosis. In hard drinkers (more then 3-4 drinks per day) however there is a increased risk of arterial hypertension, arrhythmia, hemorrhagic cerebral stroke (if more than 60 γ of alcohol per day) and alcoholic cardiomyopathy. As far as the relation between moderate alcohol drinking and the reduction of global cardiovascular risk is concerned many physiological mechanisms have been implied. It seems that the most important changes include increase of HDL-C and decrease of CRP concentration, reduction of resistance to insulin and modification in blood coagulation (fibrinolytic effect of alcohol). Up till today there are no official guidelines as far as the role of alcohol consumption in cardiovascular risk reduction is concerned. It is fully understandable due to the fact that potential benefits can be suppressed by possible damages. According to currently available recommendations, among many lifestyle modifications that can decrease the risk of chronic diseases, starting or intensification of alcohol drinking is not recommended.