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Published on: February 6, 2019
An update on alcohol and atherosclerosis
Joseph M Li1, Kenneth J Mukamal
1Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Insights
Moderate alcohol consumption is linked to reduced cardiovascular disease risk, with HDL-C and inflammatory factors playing key roles. Further research into gene-environment interactions and non-alcoholic components is needed.
Area of Science:
- Cardiovascular epidemiology
- Nutritional science
- Genetics
Background:
- Epidemiological studies consistently associate moderate alcohol intake with decreased cardiovascular disease (CVD) risk.
- Controversies persist regarding non-alcoholic constituents, genetic influences, mechanisms, and experimental validation.
Purpose of the Study:
- To review the current understanding of the relationship between moderate alcohol consumption and cardiovascular health.
- To explore the roles of high-density lipoprotein cholesterol (HDL-C), inflammatory factors, and genetic variations.
- To assess the potential impact of non-alcoholic beverage components.
Main Methods:
- Review of epidemiological studies and recent scientific evidence.
- Analysis of findings from experimental models, including animal studies.
- Examination of genetic factors, such as apolipoprotein E and interleukin 6 gene variants.
Main Results:
- Moderate alcohol use shows inverse relationships with inflammatory factors and influences high-density lipoprotein cholesterol (HDL-C).
- Animal models partially confirm ethanol's anti-atherogenic effects, implicating inflammatory pathways.
- Non-alcoholic components, particularly from red wine, demonstrate potential in vitro benefits, though human relevance is uncertain.
- Genetic factors may modulate alcohol's impact on atherosclerosis, highlighting HDL-C and inflammation as mediators.
Conclusions:
- The association between moderate drinking and reduced CVD risk warrants continued investigation.
- Future research should focus on gene-environment interactions and the translational potential of non-alcoholic compounds.
Purpose Of Review:
Epidemiological studies consistently link moderate alcohol use with a lower risk of cardiovascular disease, but a number of important issues remain controversial. These include the putative impact of non-alcoholic constituents of some alcoholic beverages, the role of genetic factors, potential mechanisms for this association, and confirmation of the relationship in experimental models.
Recent Findings:
Although high-density lipoprotein cholesterol (HDL-C) is considered the primary mediator of the cardiovascular effects of moderate drinking, recent evidence has shown the alcohol-HDL-C relation is not linear beyond the range of moderate drinking. Moderate alcohol use also has important inverse relations with inflammatory factors. Some, but not all, animal models confirm the anti-atherogenic effects of ethanol and highlight inflammatory factors as one possible mechanism. The non-alcoholic constituents of red wine also have anti-atherogenic and perhaps even life-extending properties in vitro, but their relevance to humans remains uncertain. Genetic variants of the apolipoprotein E and interleukin 6 genes in humans may modify how alcohol influences atherosclerosis, further emphasizing the importance of HDL-C and inflammatory factors as mediators.
Summary:
The robust relationship between moderate drinking and lower risk of cardiovascular disease remains an intriguing area of investigation. Clarifying potential gene-environment interactions and translational research into uses for non-alcoholic components will be important areas for future investigation.
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