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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
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Publikationsverlauf

Publikationsdatum:
23. Dezember 2011 (online)

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ABSTRACT

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.

KEYWORDS

Alcohol drinking - arrhythmias - cardiomyopathy - cerebrovascular disease - coronary artery disease - heart failure - wine - beer - liquor

REFERENCES

  • 1 Saitz R. Clinical practice. Unhealthy alcohol use.  N Engl J Med. 2005;  352 (6) 596-607
    Google Scholar
  • 2 Urbano-Marquez A, Estruch R, Navarro-Lopez F, Grau J M, Mont Ll, Rubin E. The effects of alcoholism on skeletal and cardiac muscle.  N Engl J Med. 1989;  320 (7) 409-415
    Google Scholar
  • 3 Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders.  Lancet. 2009;  373 (9682) 2223-2233
    Google Scholar
  • 4 McKee M, Britton A. The positive relationship between alcohol and heart disease in eastern Europe: potential physiological mechanisms.  J R Soc Med. 1998;  91 (8) 402-407
    Google Scholar
  • 5 Zamora-Ros R, Urpí-Sardà M, Lamuela-Raventós R M et al.. Diagnostic performance of urinary resveratrol metabolites as a biomarker of moderate wine consumption.  Clin Chem. 2006;  52 (7) 1373-1380
    Google Scholar
  • 6 Allen N E, Beral V, Casabonne D Million Women Study Collaborators et al. Moderate alcohol intake and cancer incidence in women.  J Natl Cancer Inst. 2009;  101 (5) 296-305
    Google Scholar
  • 7 Bessaoud F, Daurès J P. Patterns of alcohol (especially wine) consumption and breast cancer risk: a case-control study among a population in Southern France.  Ann Epidemiol. 2008;  18 (6) 467-475
    Google Scholar
  • 8 Grønbaek M, Becker U, Johansen D et al.. Type of alcohol consumed and mortality from all causes, coronary heart disease, and cancer.  Ann Intern Med. 2000;  133 (6) 411-419
    Google Scholar
  • 9 Pearl R. Alcohol and Longevity. New York: Knopf; 1926
    Google Scholar
  • 10 Klatsky A L. Alcohol and cardiovascular diseases: a historical overview.  Ann N Y Acad Sci. 2002;  957 7-15
    Google Scholar
  • 11 Femia R, Natali A, L'Abbate A, Ferrannini E. Coronary atherosclerosis and alcohol consumption: angiographic and mortality data.  Arterioscler Thromb Vasc Biol. 2006;  26 (7) 1607-1612
    Google Scholar
  • 12 Rimm E B, Giovannucci E L, Willett W C et al.. Prospective study of alcohol consumption and risk of coronary disease in men.  Lancet. 1991;  338 (8765) 464-468
    Google Scholar
  • 13 Di Castelnuovo A, Costanzo S, Bagnardi V, Donati M B, Iacoviello L, de Gaetano G. Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies.  Arch Intern Med. 2006;  166 (22) 2437-2445
    Google Scholar
  • 14 Costanzo S, Di Castelnuovo A, Donati M B, Iacoviello L, de Gaetano G. Alcohol consumption and mortality in patients with cardiovascular disease: a meta-analysis.  J Am Coll Cardiol. 2010;  55 (13) 1339-1347
    Google Scholar
  • 15 Mukamal K J, Ascherio A, Mittleman M A et al.. Alcohol and risk for ischemic stroke in men: the role of drinking patterns and usual beverage.  Ann Intern Med. 2005;  142 (1) 11-19
    Google Scholar
  • 16 Djoussé L, Gaziano J M. Alcohol consumption and heart failure: a systematic review.  Curr Atheroscler Rep. 2008;  10 (2) 117-120
    Google Scholar
  • 17 Lippi G, Franchini M, Favaloro E J, Targher G. Moderate red wine consumption and cardiovascular disease risk: beyond the “French paradox”.  Semin Thromb Hemost. 2010;  36 (1) 59-70
    Google Scholar
  • 18 Ettinger P O, Wu C F, De La Cruz Jr C, Weisse A B, Ahmed S S, Regan T J. Arrhythmias and the “Holiday Heart”: alcohol-associated cardiac rhythm disorders.  Am Heart J. 1978;  95 (5) 555-562
    Google Scholar
  • 19 Cohen E J, Klatsky A L, Armstrong M A. Alcohol use and supraventricular arrhythmia.  Am J Cardiol. 1988;  62 (13) 971-973
    Google Scholar
  • 20 Mukamal K J, Tolstrup J S, Friberg J, Jensen G, Grønbaek M. Alcohol consumption and risk of atrial fibrillation in men and women: the Copenhagen City Heart Study.  Circulation. 2005;  112 (12) 1736-1742
    Google Scholar
  • 21 Conen D, Tedrow U B, Cook N R, Moorthy M V, Buring J E, Albert C M. Alcohol consumption and risk of incident atrial fibrillation in women.  JAMA. 2008;  300 (21) 2489-2496
    Google Scholar
  • 22 Klatsky A L, Gunderson E. Alcohol and hypertension. In: Mohler E R, Townsend R R, eds. Advanced Therapy in Hypertension and Vascular Disease. Hamilton, Ontario: BC Decker Press; 2006: 108-117
    Google Scholar
  • 23 Demakis J G, Proskey A, Rahimtoola S H et al.. The natural course of alcoholic cardiomyopathy.  Ann Intern Med. 1974;  80 (3) 293-297
    Google Scholar
  • 24 Kasper E K, Agema W R, Hutchins G M, Deckers J W, Hare J M, Baughman K L. The causes of dilated cardiomyopathy: a clinicopathologic review of 673 consecutive patients.  J Am Coll Cardiol. 1994;  23 (3) 586-590
    Google Scholar
  • 25 Böllinger O. Ueber die Haussigkeit und Ursachen der idiopathischen Herzhypertrophie in München.  Disch Med Wochenschr (Stuttgart). 1884;  10 180
    Google Scholar
  • 26 Steell G. Textbook on Diseases of the Heart. Philadelphia: Blakiston Press; 1906: 76-
    Google Scholar
  • 27 MacKenzie J. The Study of the Pulse. Edinburgh: Y. J. Pentland Press; 1902: 237
    Google Scholar
  • 28 Richardson P J, Patel V B, Preedy V R. Alcohol and the myocardium. In: Chadwick D J, Goode JA, eds. Alcohol and Cardiovascular Diseases. Novartis Found Symposium # 216. New York: Wiley Press; 1998: 35-50
    Google Scholar
  • 29 Urbano-Márquez A, Fernández-Solà J. Effects of alcohol on skeletal and cardiac muscle.  Muscle Nerve. 2004;  30 (6) 689-707
    Google Scholar
  • 30 Kaphalia B S, Cai P, Khan M F, Okorodudu A O, Ansari G A. Fatty acid ethyl esters: markers of alcohol abuse and alcoholism.  Alcohol. 2004;  34 (2-3) 151-158
    Google Scholar
  • 31 Laposata E A, Lange L G. Presence of nonoxidative ethanol metabolism in human organs commonly damaged by ethanol abuse.  Science. 1986;  231 (4737) 497-499
    Google Scholar
  • 32 Pasotti M, Repetto A, Tavazzi L, Arbustini E. Genetic predisposition to heart failure.  Med Clin North Am. 2004;  88 (5) 1173-1192
    Google Scholar
  • 33 Klatsky A. Drink to your health?.  Sci Am. 2003;  288 (2) 74-81
    Google Scholar
  • 34 Kloner R A, Rezkalla S H. To drink or not to drink? That is the question.  Circulation. 2007;  116 (11) 1306-1317
    Google Scholar
  • 35 O'Keefe J H, Bybee K A, Lavie C J. Alcohol and cardiovascular health: the razor-sharp double-edged sword.  J Am Coll Cardiol. 2007;  50 (11) 1009-1014
    Google Scholar
  • 36 Ikehara S, Iso H, Toyoshima H Japan Collaborative Cohort Study Group et al. Alcohol consumption and mortality from stroke and coronary heart disease among Japanese men and women: the Japan collaborative cohort study.  Stroke. 2008;  39 (11) 2936-2942
    Google Scholar
  • 37 Reynolds K, Lewis B, Nolen JD, Kinney G L, Sathya B, He J. Alcohol consumption and risk of stroke: a meta-analysis.  JAMA. 2003;  289 (5) 579-588
    Google Scholar
  • 38 Jepson R G, Fowkes F G, Donnan P T, Housley E. Alcohol intake as a risk factor for peripheral arterial disease in the general population in the Edinburgh Artery Study.  Eur J Epidemiol. 1995;  11 (1) 9-14
    Google Scholar
  • 39 Vliegenthart R, Geleijnse J M, Hofman A et al.. Alcohol consumption and risk of peripheral arterial disease: the Rotterdam study.  Am J Epidemiol. 2002;  155 (4) 332-338
    Google Scholar
  • 40 Iestra J A, Kromhout D, van der Schouw Y T, Grobbee D E, Boshuizen H C, van Staveren W A. Effect size estimates of lifestyle and dietary changes on all-cause mortality in coronary artery disease patients: a systematic review.  Circulation. 2005;  112 (6) 924-934
    Google Scholar
  • 41 Mukamal K J. Alcohol use and prognosis in patients with coronary heart disease.  Prev Cardiol. 2003;  6 (2) 93-98
    Google Scholar
  • 42 Janszky I, Ljung R, Ahnve S, Hallqvist J, Bennet A M, Mukamal K J. Alcohol and long-term prognosis after a first acute myocardial infarction: the SHEEP study.  Eur Heart J. 2008;  29 (1) 45-53
    Google Scholar
  • 43 Klatsky A L, Chartier D, Udaltsova N et al.. Alcohol drinking and risk of hospitalization for heart failure with and without associated coronary artery disease.  Am J Cardiol. 2005;  96 (3) 346-351
    Google Scholar
  • 44 Walsh C R, Larson M G, Evans J C et al.. Alcohol consumption and risk for congestive heart failure in the Framingham Heart Study.  Ann Intern Med. 2002;  136 (3) 181-191
    Google Scholar
  • 45 Aguilar D, Skali H, Moyé L A et al.. Alcohol consumption and prognosis in patients with left ventricular systolic dysfunction after a myocardial infarction.  J Am Coll Cardiol. 2004;  43 (11) 2015-2021
    Google Scholar
  • 46 Klatsky A L, Armstrong M A, Friedman G D, Sidney S. Alcohol drinking and risk of hemorrhagic stroke.  Neuroepidemiology. 2002;  21 (3) 115-122
    Google Scholar
  • 47 Iso H, Baba S, Mannami T JPHC Study Group et al. Alcohol consumption and risk of stroke among middle-aged men: the JPHC Study Cohort I.  Stroke. 2004;  35 (5) 1124-1129
    Google Scholar
  • 48 Klatsky A L, Armstrong M A, Friedman G D, Sidney S. Alcohol drinking and risk of hospitalization for ischemic stroke.  Am J Cardiol. 2001;  88 (6) 703-706
    Google Scholar
  • 49 Van Gign J, Stampfer M J, Wolfe C, Algra A. The association between alcohol consumption and stroke. In: Verschuren P M, ed. Health Issues Related to Alcohol Consumption. Washington, D.C: ILSI Press; 1993: 43-80
    Google Scholar
  • 50 Klatsky A L. Alcohol and stroke: an epidemiological labyrinth.  Stroke. 2005;  36 (9) 1835-1836
    Google Scholar
  • 51 Stampfer M J, Colditz G A, Willett W C, Speizer F E, Hennekens C H. A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women.  N Engl J Med. 1988;  319 (5) 267-273
    Google Scholar
  • 52 Corrao G, Bagnardi V, Zambon A, La Vecchia C. A meta-analysis of alcohol consumption and the risk of 15 diseases.  Prev Med. 2004;  38 (5) 613-619
    Google Scholar
  • 53 Feinman L, Lieber C S. Ethanol and lipid metabolism.  Am J Clin Nutr. 1999;  70 (5) 791-792
    Google Scholar
  • 54 Koppes L L, Dekker J M, Hendriks H F, Bouter L M, Heine R J. Moderate alcohol consumption lowers the risk of type 2 diabetes: a meta-analysis of prospective observational studies.  Diabetes Care. 2005;  28 (3) 719-725
    Google Scholar
  • 55 Avogaro A, Watanabe R M, Dall'Arche A, De Kreutzenberg S V, Tiengo A, Pacini G. Acute alcohol consumption improves insulin action without affecting insulin secretion in type 2 diabetic subjects.  Diabetes Care. 2004;  27 (6) 1369-1374
    Google Scholar
  • 56 Estruch R, Sacanella E, Mota F et al.. Moderate consumption of red wine, but not gin, decreases erythrocyte superoxide dismutase activity: a randomised cross-over trial.  Nutr Metab Cardiovasc Dis. 2011;  21 (1) 46-53
    Google Scholar
  • 57 Estruch R, Sacanella E, Badia E et al.. Different effects of red wine and gin consumption on inflammatory biomarkers of atherosclerosis: a prospective randomized crossover trial.  Atherosclerosis. 2004;  175 (1) 117-123
    Google Scholar
  • 58 Rimm E B, Williams P, Fosher K, Criqui M, Stampfer M J. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors.  BMJ. 1999;  319 (7224) 1523-1528
    Google Scholar
  • 59 Collins M A, Neafsey E J, Mukamal K J et al.. Alcohol in moderation, cardioprotection, and neuroprotection: epidemiological considerations and mechanistic studies.  Alcohol Clin Exp Res. 2009;  33 (2) 206-219
    Google Scholar
  • 60 Kodavali L, Townsend R R. Alcohol and its relationship to blood pressure.  Curr Hypertens Rep. 2006;  8 (4) 338-344
    Google Scholar
  • 61 Chobanian A V, Bakris G L, Black H R National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report.  JAMA. 2003;  289 (19) 2560-2572
    Google Scholar
  • 62 Sesso H D, Cook N R, Buring J E, Manson J E, Gaziano J M. Alcohol consumption and the risk of hypertension in women and men.  Hypertension. 2008;  51 (4) 1080-1087
    Google Scholar
  • 63 Klatsky A L, Friedman G D, Siegelaub A B, Gérard M J. Alcohol consumption and blood pressure Kaiser-Permanente Multiphasic Health Examination data.  N Engl J Med. 1977;  296 (21) 1194-1200
    Google Scholar
  • 64 Klatsky A L, Friedman G D, Armstrong M A. The relationships between alcoholic beverage use and other traits to blood pressure: a new Kaiser Permanente study.  Circulation. 1986;  73 (4) 628-636
    Google Scholar
  • 65 Potter J F, Beevers D G. Pressor effect of alcohol in hypertension.  Lancet. 1984;  1 (8369) 119-122
    Google Scholar
  • 66 Puddey I B, Beilin L J, Vandongen R, Rouse I L, Rogers P. Evidence for a direct effect of alcohol consumption on blood pressure in normotensive men. A randomized controlled trial.  Hypertension. 1985;  7 (5) 707-713
    Google Scholar
  • 67 Parker M, Puddey I B, Beilin L J, Vandongen R. Two-way factorial study of alcohol and salt restriction in treated hypertensive men.  Hypertension. 1990;  16 (4) 398-406
    Google Scholar
  • 68 Zilkens R R, Burke V, Hodgson J M, Barden A, Beilin L J, Puddey I B. Red wine and beer elevate blood pressure in normotensive men.  Hypertension. 2005;  45 (5) 874-879
    Google Scholar
  • 69 Puddey I B, Parker M, Beilin L J, Vandongen R, Masarei J R. Effects of alcohol and caloric restrictions on blood pressure and serum lipids in overweight men.  Hypertension. 1992;  20 (4) 533-541
    Google Scholar
  • 70 Cox K L, Puddey I B, Morton A R, Masarei J R, Vandongen R, Beilin L J. Controlled comparison of effects of exercise and alcohol on blood pressure and serum high density lipoprotein cholesterol in sedentary males.  Clin Exp Pharmacol Physiol. 1990;  17 (4) 251-255
    Google Scholar
  • 71 Klatsky A L, Koplik S, Gunderson E, Kipp H, Friedman G D. Sequelae of systemic hypertension in alcohol abstainers, light drinkers, and heavy drinkers.  Am J Cardiol. 2006;  98 (8) 1063-1068
    Google Scholar
  • 72 Friedman G D, Klatsky A L, Siegelaub A B. Alcohol, tobacco, and hypertension.  Hypertension. 1982;  4 (5 Pt 2, suppl III) III143-III150
    Google Scholar
  • 73 Langer R D, Criqui M H, Reed D M. Lipoproteins and blood pressure as biological pathways for effect of moderate alcohol consumption on coronary heart disease.  Circulation. 1992;  85 (3) 910-915
    Google Scholar
  • 74 Criqui M H, Golomb B A. Epidemiologic aspects of lipid abnormalities.  Am J Med. 1998;  105 (1A) 48S-57S
    Google Scholar
  • 75 Gaziano J M, Buring J E, Breslow J L et al.. Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction.  N Engl J Med. 1993;  329 (25) 1829-1834
    Google Scholar
  • 76 Corella D, Tucker K, Lahoz C et al.. Alcohol drinking determines the effect of the APOE locus on LDL-cholesterol concentrations in men: the Framingham Offspring Study.  Am J Clin Nutr. 2001;  73 (4) 736-745
    Google Scholar
  • 77 Holvoet P, Mertens A, Verhamme P et al.. Circulating oxidized LDL is a useful marker for identifying patients with coronary artery disease.  Arterioscler Thromb Vasc Biol. 2001;  21 (5) 844-848
    Google Scholar
  • 78 Briel M, Ferreira-Gonzalez I, You J J et al.. Association between change in high density lipoprotein cholesterol and cardiovascular disease morbidity and mortality: systematic review and meta-regression analysis.  BMJ. 2009;  338 b92
    Google Scholar
  • 79 Hendriks H F, van der Gaag M S. Alcohol, coagulation and fibrinolysis.  Novartis Found Symp. 1998;  216 111-120 discussion 120-124
    Google Scholar
  • 80 Ridker P M, Vaughan D E, Stampfer M J, Glynn R J, Hennekens C H. Association of moderate alcohol consumption and plasma concentration of endogenous tissue-type plasminogen activator.  JAMA. 1994;  272 (12) 929-933
    Google Scholar
  • 81 Wannamethee S G, Lowe G D, Shaper G et al.. The effects of different alcoholic drinks on lipids, insulin and haemostatic and inflammatory markers in older men.  Thromb Haemost. 2003;  90 (6) 1080-1087
    Google Scholar
  • 82 Di Minno M N, Tremoli E, Tufano A, Russolillo A, Lupoli R, Di Minno G. Exploring newer cardioprotective strategies: ω-3 fatty acids in perspective.  Thromb Haemost. 2010;  104 (4) 664-680
    Google Scholar
  • 83 de Lorgeril M, Salen P, Martin J L, Boucher F, de Leiris J. Interactions of wine drinking with omega-3 fatty acids in patients with coronary heart disease: a fish-like effect of moderate wine drinking.  Am Heart J. 2008;  155 (1) 175-181
    Google Scholar
  • 84 Di Castelnuovo A, Costanzo S, Donati MB, Iacoviello L, de Gaetano G. Prevention of cardiovascular risk by moderate alcohol consumption: epidemiologic evidence and plausible mechanisms.  Intern Emerg Med. 2010;  5 (4) 291-297
    Google Scholar
  • 85 Ruf J C, Berger J L, Renaud S. Platelet rebound effect of alcohol withdrawal and wine drinking in rats. Relation to tannins and lipid peroxidation.  Arterioscler Thromb Vasc Biol. 1995;  15 (1) 140-144
    Google Scholar
  • 86 Soleas G J, Diamandis E P, Goldberg D M. Wine as a biological fluid: history, production, and role in disease prevention.  J Clin Lab Anal. 1997;  11 (5) 287-313
    Google Scholar
  • 87 Guarda E, Godoy I, Foncea R et al.. Red wine reduces oxidative stress in patients with acute coronary syndrome.  Int J Cardiol. 2005;  104 (1) 35-38
    Google Scholar
  • 88 Tsang C, Higgins S, Duthie G G et al.. The influence of moderate red wine consumption on antioxidant status and indices of oxidative stress associated with CHD in healthy volunteers.  Br J Nutr. 2005;  93 (2) 233-240
    Google Scholar
  • 89 Sacanella E, Vázquez-Agell M, Mena M P et al.. Down-regulation of adhesion molecules and other inflammatory biomarkers after moderate wine consumption in healthy women: a randomized trial.  Am J Clin Nutr. 2007;  86 (5) 1463-1469
    Google Scholar
  • 90 De Curtis A, Murzilli S, Di Castelnuovo A et al.. Alcohol-free red wine prevents arterial thrombosis in dietary-induced hypercholesterolemic rats: experimental support for the ‘French paradox’.  J Thromb Haemost. 2005;  3 (2) 346-350
    Google Scholar
  • 91 DiMinno G, Silver M J. Mouse antithrombotic assay: a simple method for the evaluation of antithrombotic agents in vivo. Potentiation of antithrombotic activity by ethyl alcohol.  J Pharmacol Exp Ther. 1983;  225 (1) 57-60
    Google Scholar
  • 92 Pace-Asciak C R, Rounova O, Hahn S E, Diamandis E P, Goldberg D M. Wines and grape juices as modulators of platelet aggregation in healthy human subjects.  Clin Chim Acta. 1996;  246 (1-2) 163-182
    Google Scholar
  • 93 Rotondo S, Rotilio D, Cerletti C, de Gaetano G. Red wine, aspirin and platelet function.  Thromb Haemost. 1996;  76 (5) 818-819
    Google Scholar
  • 94 Rotondo S, Rajtar G, Manarini S et al.. Effect of trans-resveratrol, a natural polyphenolic compound, on human polymorphonuclear leukocyte function.  Br J Pharmacol. 1998;  123 (8) 1691-1699
    Google Scholar
  • 95 Di Castelnuovo A, Costanzo S, Donati M B, Iacoviello L, de Gaetano G. Prevention of cardiovascular risk by moderate alcohol consumption: epidemiologic evidence and plausible mechanisms.  Intern Emerg Med. 2010;  5 (4) 291-297
    Google Scholar
  • 96 Naimi T S, Brown D W, Brewer R D et al.. Cardiovascular risk factors and confounders among nondrinking and moderate-drinking U.S. adults.  Am J Prev Med. 2005;  28 (4) 369-373
    Google Scholar
  • 97 Jackson R, Broad J, Connor J, Wells S. Alcohol and ischaemic heart disease: probably no free lunch.  Lancet. 2005;  366 (9501) 1911-1912
    Google Scholar
  • 98 Mukamal K J, Ding E L, Djoussé L. Alcohol consumption, physical activity, and chronic disease risk factors: a population-based cross-sectional survey.  BMC Public Health. 2006;  6 118
    Google Scholar
  • 99 Di Castelnuovo A, Rotondo S, Iacoviello L, Donati M B, De Gaetano G. Meta-analysis of wine and beer consumption in relation to vascular risk.  Circulation. 2002;  105 (24) 2836-2844
    Google Scholar
  • 100 Klatsky A L. Alcohol and cardiovascular health.  Physiol Behav. 2010;  100 (1) 76-81
    Google Scholar
  • 101 Di Castelnuovo A, Iacoviello L, de Gaetano G. Alcohol and coronary heart disease.  N Engl J Med. 2003;  348 (17) 1719-1722 author reply 1719-1722
    Google Scholar
  • 102 Grønbaek M, Di Castelnuovo A, Iacoviello L et al.. Wine, alcohol and cardiovascular risk: open issue.  J Thromb Haemost. 2004;  2 (11) 2041-2048
    Google Scholar
  • 103 Ursini F, Zamburlini A, Cazzolato G, Maiorino M, Bon G B, Sevanian A. Postprandial plasma lipid hydroperoxides: a possible link between diet and atherosclerosis.  Free Radic Biol Med. 1998;  25 (2) 250-252
    Google Scholar
  • 104 McElduff P, Dobson A J. How much alcohol and how often? Population based case-control study of alcohol consumption and risk of a major coronary event.  BMJ. 1997;  314 (7088) 1159-1164
    Google Scholar
  • 105 Kauhanen J, Kaplan G A, Goldberg D E, Salonen J T. Beer binging and mortality: results from the Kuopio ischaemic heart disease risk factor study, a prospective population based study.  BMJ. 1997;  315 (7112) 846-851
    Google Scholar
  • 106 Mukamal K J, Conigrave K M, Mittleman M A et al.. Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men.  N Engl J Med. 2003;  348 (2) 109-118
    Google Scholar
  • 107 Anstie F E. On the Uses of Wines in Health and Disease. New York: J.S. Redfield; 1870: 11-13
    Google Scholar
  • 108 Friedman G D, Klatsky A L. Is alcohol good for your health?.  N Engl J Med. 1993;  329 (25) 1882-1883
    Google Scholar
  • 109 Klatsky A L. Should patients with heart disease drink alcohol? (Editorial.)  JAMA. 2001;  285 (15) 2004-2006
    Google Scholar
  • 110 McCann S E, Sempos C, Freudenheim J L et al.. Alcoholic beverage preference and characteristics of drinkers and nondrinkers in western New York (United States).  Nutr Metab Cardiovasc Dis. 2003;  13 (1) 2-11
    Google Scholar

Matteo Nicola Dario Di MinnoM.D. 

Clinica Medica, Centro di Riferimento Regionale, per le Emocoagulopatie

AOUP “FEDERICO II,” Via S. Pansini 5, 80131 Napoli

eMail: dario.diminno@hotmail.it

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