Alcohol and Cardiovascular Function

Abstract

The effects of alcohol consumption vary considerably and depend on the concentration and dose, together with various other factors, such as nutritional status, gender, and ethnicity. The present chapter analyzes the main medical consequences related to alcohol consumption on cardiovascular system. Low-to-moderate ethanol consumption has been linked to a reduced cardiovascular risk, with a J-shaped or U-shaped dose-response curve. However, alcohol intake has been associated with several cardiovascular diseases, such as hypertension, cardiomyopathy, coronary artery disease, and stroke. In particular, chronic alcohol consumption induces several alterations in the cardiovascular system, including low-grade systemic inflammation, hyperuricemia, dyslipidemia, hyperhomocysteinemia, increased oxidative stress with enhanced lipid peroxidation, impaired glucose tolerance with insulin resistance, endothelial dysfunction, arterial hypertension, and alcoholic cardiomyopathy. From a clinical point of view, all the mentioned mechanisms are able to modify the pathophysiology of atherosclerosis. In sum, although several studies have described a J-shaped or U-shaped curve to describe the relationship between alcohol intake and total and cardiovascular mortality, these studies have been observational and epidemiological in nature. Promoting alcohol for those who do not drink and/or the use of alcohol as a cardioprotective strategy is not recommended.