Added to this, some factors are critical in the interpretation of the health effects of alcohol consumption in available studies such as the measurement of alcohol consumption (and its misreporting) or the size of the drink (and the respective alcohol concentration). Alcohol has a hormetic physiological behavior that results in either increased or decreased CV risk depending on the amount consumed, drinking frequency, pattern of consumption (irregular or heavy/binge drinking, which is not uniformly defined), and the outcome under study, or even the type of alcoholic beverage consumed. Īlthough moderate alcohol intake may have long-term CV benefits, even low consumption may have some risk. In 2016, 32.5% (25% women and 39% men) were current drinkers, and the mean amount of alcohol consumed was 0.73 standard drinks daily for females and 1.7 standard drinks daily for males. However, alcohol consumption guidelines vary substantially across the globe: low-risk guidelines range from 10–42 g/day or 98–140 g/week for women and 10–56 g/day or 150–280 g/week for men. Īccording to the Dietary Guidelines Advisory Committee (US), if alcohol is consumed, it should be consumed in moderation (≤1 and 2 drinks/day for women and men, respectively) and only by adults of legal drinking age. As a matter of fact, alcohol use, besides the associated mental disorders caused by dependence, was the seventh leading risk factor for both deaths and disability-adjusted life years in 2016, accounting for 2.2% and 6.8% of total age-standardized deaths among females and males, respectively, and it has been identified as a major contributor to the burden of disease all over the globe. Whereas the majority of studies have found that low–moderate alcohol consumption may be beneficial -or at least not harmful -for the CV system by reducing the risk of major adverse CV events (MACE), excessive alcohol consumption increases the risk of CVD and is associated with increased risk of more than 50 diseases.
For health systems, alcohol consumption has been a matter of strong debate, because findings from different studies on the effects of alcohol in CVD have been contradictory. The influence of modifiable risk factors, such as smoking, high blood pressure, dyslipidemia, or poor diet, has been the object of investigation since the 1950s, and studies, such as the Framingham Heart Study or the INTERHEART study, have shown that 90% of acute myocardial infarctions (AMIs) are attributable to potentially reversible risk factors, making the reduction of CV risk factors a high priority at the national and global levels. Besides new evidence associating low and moderate alcohol consumption with decreased risk of cardiovascular disease, several questions remain unanswered related to the concrete amount of safe consumption, the type of alcoholic beverage, and the age-, sex-, and genetic/ethnical-specific differences in alcohol consumption.Ĭardiovascular disease (CVD) is the leading cause of mortality in Europe (47% of total mortality) and one of the main causes of death worldwide (31% of all worldwide deaths).
Thus, the aim of this review was to critically discuss the current knowledge on the relationship between alcohol intake and cardiovascular disease. This is why the cardiovascular benefits of low–moderate alcohol consumption are being questioned and perhaps might have been overestimated. However, the vast majority of studies elucidating the role of alcohol in cardiovascular and in the global burden of disease relies on epidemiological studies of associative nature which carry several limitations. Alcohol has a hormetic physiological behavior that results in either increased or decreased cardiovascular risk depending on the amount consumed, drinking frequency, pattern of consumption, and the outcomes under study or even the type of alcoholic beverage consumed.
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