Light alcohol consumption and coronary heart disease: potential mechanisms and current debate

Abstract

The majority of epidemiological research has suggested that regular light alcohol consumption can have a beneficial effect on cardiovascular health. Recent research suggests that this effect may differ for different cardiovascular disease outcomes. In this thesis, several mechanisms are outlined by which alcohol may exert a beneficial effect on coronary heart disease, a subset of cardiovascular diseases. Regular light consumption of alcohol alters both LDL and HDL-metabolism, thereby reducing development of atherosclerosis. The hemostatic processes coagulation and fibrinolysis are also altered and may reduce development of thrombosis. Epidemiological findings suggest that of these four mechanistic alterations, changes in HDL-metabolism and coagulation contribute strongly to the total cardioprotection caused by light alcohol consumption. Differences in genetic make-up may be responsible for individual differences in alcohol-induced cardioprotection. Recent research points to alternative explanations for the lowered risk of cardiovascular disease: reverse causality, confounding and heterogeneous associations for different cardiovascular disease outcomes. These alternative explanation support the current alcohol consumption guidelines by the National Health Council of the Netherlands.