"Alcohol consumption increases
the risk of CVD(20). In the Global
Action Plan for Prevention and
Control of NCDs, the World
Health Organization (WHO) calls
for a 10% relative reduction in the per
capita use of alcohol between 2013-
2030 (21). Based on recent evidence, it
has been concluded that there is “no
safe level of alcohol consumption”(5).
Risks attributable to alcohol use increase for all
the major categories of CVD(20). Thus, alcohol
increases the risk for hypertensive heart
disease, cardiomyopathy, atrial fibrillation
and flutter, and strokes. In moderate drinkers,
the risk of stroke is 1.14 times greater (95%
CI, 1.10-1.17); coronary disease (excluding
myocardial infarction) is 1.06 (95% CI, 1.00
– 1.11); heart failure is 1.09 (95% CI, 1.03-
1.15); fatal hypertensive disease 1.24 (95%
CI, 1.15-1.33) and fatal aortic aneurysm is
1.15 times greater (95% CI, 1.03-1.28)(20)
than for non-drinkers. It has been argued that
people with moderate consumption and no
binge episodes may appear to have a slightly
lower risk of ischaemic heart disease (IHD),
but the protective effect of moderate alcohol
consumption for IHD has been challenged
as the evidence is based entirely upon
non-randomized studies(22)"
An increase in high-density lipo-protein (HDL)
cholesterol has been the most compelling
potential source of biologic plausibility for
how alcohol might help prevent CVD. However,
the cardioprotective effect of HDL is under
challenge: many studies find no effect from
increased HDL levels on reducing the risk for
myocardial infarction(23)(24)(25).
Other proposed cardioprotective biological
mechanisms have also been shown to be
inconsistent with sound epidemiologic
studies. These include coronary calcification
and carotid intima-media thickness, where
alcohol consumption is associated with worse
vascular health(26)(27).
Contrary to popular opinion, alcohol is not
good for the heart. This directly contradicts
the common message over the past three
decades from some researchers, the alcohol
industry, and the media that alcohol prolongs
life, chiefly by reducing the risk of CVD.
For example, the use of red wine has been
promoted through various diets as a
“heart-healthy” beverage for the longest time.
The presence of resveratrol in wine has been
known for its cardioprotective characteristics
in light to moderate drinkers. However, there
are multiple reasons that the belief that
alcohol is good for cardiovascular health is
no longer acceptable:
• Such evidence has been based on
observational studies
• No randomized controlled trials (RCTs)
have confirmed health benefits of
alcohol
• The presence of unaccounted
confounding factors further weakens
the quality of evidence
• Studies misclassify unhealthy ex-drinkers
as abstainers
• Most evidence is observed only in the
Caucasian population
• Studies that show positive effects are
funded by the alcohol industry.*
Research in the latest decade has led
to major reversals in the perception
of alcohol in relation to health in
general and CVD in particular. These
developments have prompted health
authorities in a number of countries,
e.g. the Netherlands(28), England(29) and
Australia(30), to lower their recommended
amount of alcohol for low-risk drinking.
The alcohol industry has also perpetuated
misleading information about the benefits
of drinking alcohol. This interference by
the alcohol industry closely reflects the
universally vilified activities of tobacco
companies. Alcohol industries deceptively
promote their products under the labels of
“healthy” and “safe”. Portrayal of alcohol
in print and electronic media as necessary
for a vibrant social life has diverted
attention from the harms of alcohol
use. Youth-targeted advertisement and
encouraging alcohol as “heart-healthy”
have created a conducive environment
for young adults to relate alcohol with
‘having a good time’. Contrary to this
belief, evidence from all around the world
exists to link alcohol with a range of noncommunicable and infectious diseases."
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