Drink to your health - is alcohol really cardioprotective?
In the April 2007 edition of the New Zealand Family Physician is a clinical review Drink to your health is alcohol really cardioprotective? by Graham Gulbransen and Ross McCormick which begins: A convenient and widely held belief is that a few drinks are good for the heart. This view is based largely on epidemiological studies similar to those that mistakenly showed that menopausal hormone replacement therapy (HRT) was cardioprotective. Because of confounding and misclassification, non-randomised uncontrolled studies can never confirm such beliefs. This article reviews the medical literature on alcohol and coronary heart disease (CHD), looking at evidence for and against cardioprotection.
The review starts with an introduction:
"In 1926 Raymond Pearl first described the J-shaped alcohol-mortality curve: moderately alcoholised fowls had the lowest mortality, followed by those not exposed, with heavily alcoholised fowls having the highest mortality!
"In the past 30 years more than 100 epidemiological studies have suggested that moderate alcohol consumption (in humans!) is cardioprotective. In New Zealand we follow the Alcohol Advisory Council of New Zealand guidelines that define safer or moderate drinking as up to 20 grams of alcohol daily for women and 30 grams for men. However, a 1987 Lancet editorial, Dying for a Drink urged caution, The higher mortality among abstainers has not been fully explained but may well be a spurious finding in a group of men who may be at higher risk for other reasons The U [J] shaped curve has been interpreted uncritically The message we should be delivering unequivocally is that alcohol is bad for health."
NZFP Volume 34 Number 2, April 2007 122-126. 2007 The Royal New Zealand College of General Practitioners
Drink to your health is alcohol really cardioprotective? Graham Gulbransen and Ross McCormick. Correspondence to Graham Gulbransen gg@woosh.co.nz
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