In vino veritas: alcohol and heart disease

Numerous epidemiological studies, numbering nearly 100, have documented an inverse association between alcohol consumption and vascular risk. The preponderance of evidence supports an independent beneficial effect of mild-to-moderate alcoholic beverage consumption on risk of coronary heart disease (CHD). However, it is important to remember that observational data cannot prove causation; unmeasured or incompletely controlled confounding factors cannot be excluded. That said, most authorities now attribute a causal role to the relationship: moderate alcohol consumption reduces the risk of CHD, and current research centers on the mechanistic underpinnings and whether patterns of drinking are important. Here, I review the association between alcohol use and CHD risk, explore putative mechanisms, and make recommendations.