Alcohol

Abstract

Pathologists had often noted relative absence of atheroma at post mortem examination of high alcohol consumers. Klatsky (1974) reported the first epidemiological study suggesting alcohol protects against CHD. In the years 1977–1999 many prospective studies reported on estimated alcohol intake (Table 19.1 has examples): moderate consumption, 1–4 drinks per day have been generally found protective against CHD. Public health authorities cannot, however, recommend alcohol because its responsibility for violence and accidents in young people removes more life-years than are saved by the CHD benefit in older people in affluent communities.

The best established mechanism for alcohol’s protective effect is that it raises HDL-cholesterol. Although red wine contains more antioxidants, no specific disease benefit has been associated with one type of beverage. Years 1974–1997.