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(Hypertension. 2005;45:851.)
© 2005 American Heart Association, Inc.

Editorial Commentaries

Vascular Effects of Alcoholic Beverages

Is It Only Alcohol That Matters?

Flávio D. Fuchs

From the Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Correspondence to Flávio Danni Fuchs, Serviço de Cardiologia, Sala 2061, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, 90.035-903, Porto Alegre, RS, Brazil. E-mail ffuchs@hcpa.ufrgs.br

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The relationship between alcoholic beverage consumption and cardiovascular disease is complex and not fully elucidated. The idea that drinking moderately protects against coronary heart disease prevails among physicians and the public at large. There are 218 reviews in MedLine under the search terms "coronary heart disease alcohol," limited to title and abstract, almost all asserting that the consumption of moderate amounts of alcoholic beverages is beneficial for cardiovascular health. Wine is the beverage typically associated with cardioprotection, being presumably a determinant of the low incidence of CHD in France, the French paradox. The epidemiological evidence comes along with the demonstration of beneficial effects of alcohol or other wine products on some mediators of cardiovascular disease, such as blood lipoproteins, clotting and fibrinolytic factors, insulin sensitivity, endothelin, NO, and LDL susceptibility to oxidation. However, not all epidemiological studies have shown a cardiovascular protection derived from the moderate consumption of alcoholic beverages. In blacks, this amount of consumption was associated with an increased risk for coronary heart disease incidence.¹ The observational design of studies that have demonstrated the beneficial effect of alcoholic beverages precluded the full control of confounding by a healthier lifestyle of moderate drinkers. In addition, other negative cardiovascular effects of alcohol could nullify its beneficial effects. Among the harmful effects of alcoholic beverages is their blood pressure–raising effect. Drinkers of alcoholic beverages have higher blood pressure² or are at higher risk for developing hypertension.³ A J-shaped relationship between blood pressure and ingestion of alcoholic beverages has been described by . . . [Full Text of this Article]

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