Semin Thromb Hemost 2011; 37(8): 875-884
DOI: 10.1055/s-0031-1297366
© Thieme Medical Publishers

Alcohol Dosing and the Heart: Updating Clinical Evidence

Matteo Nicola Dario Di Minno1 , Massimo Franchini2 , Anna Russolillo1 , Roberta Lupoli1 , Salvatore Iervolino1 , Giovanni Di Minno1
  • 1Department of Clinical and Experimental Medicine, “Federico II” University, Naples, Italy
  • 2Immunohematology and Transfusion Center, Department of Pathology and Laboratory Medicine, University Hospital of Parma, Italy
Further Information

Publication History

Publication Date:
23 December 2011 (online)


The consequences of heavy or irregular alcohol drinking have long been known. Recently, consistent information has been provided in support of an association between light/moderate alcohol consumption and protection from vascular and all-cause mortality, ischemic stroke, peripheral arterial disease, congestive heart failure, and recurrence of ischemic events. After reviewing the information with respect to major aspects of cardiovascular pathophysiology, to potential confounders and to underlying mechanisms, several concepts emerge. First, the recommended amounts of “safe alcohol drinking” in healthy individuals are up to two standard drinks (∼20 g/d) for a man and up to one drink (10 g/d) for a nonpregnant woman. The overall balance for young premenopausal women, but not for older women, would be unfavorable for drinking. The risk of cancer would not outweigh potential benefits of alcohol on heart disease. Second, within the frame of a balanced pattern of dietary energy intake, patients with cardiovascular disease who drink alcohol should not exceed one or two standard drinks per day for women or up to two or three drinks per day for men. Third, the low rates of coronary heart disease among the Mediterranean people may be related to their pattern of drinking wine every day during meals. Regular drinking is associated with better outcomes than occasional (binge)/weekly drinking. Fourth, wine (ethanol with antioxidants) exhibits significantly higher anti-inflammatory effects than gin (ethanol without polyphenols), and thus in general wine should be preferred to liquor or beer.


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Matteo Nicola Dario Di Minno, M.D. 

Clinica Medica, Centro di Riferimento Regionale, per le Emocoagulopatie

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