Alcohol and cardiovascular risk

Abstract

Alcohol is a psychoactive substance that has a considerable impact on the physical and mental health of individuals. While there is clear evidence for a wide range of harms associated with alcohol consumption, research has also been conducted into the potential positive effects, including cardiovascular effects. The results of many of these studies are suggestive of a J-shaped association between low levels of regular alcohol intake and a reduction in cardiovascular risk - particularly coronary heart disease risk. This is an association that appears to be affected both by the level and the pattern of alcohol consumption. However, most of this research has consisted of observational and population-based studies, with inherent methodological limitations and difficulties controlling for confounding factors. Consequently, there is still insufficient evidence to suggest a causal relationship between alcohol consumption and a reduction in cardiovascular risk. On a population level, the putative benefits of alcohol intake are more salient for some individuals compared to others - such as older adults with other cardiovascular risk factors. On the other hand, negative health effects can arise from even low levels of alcohol intake. Thus, the provision of advice regarding alcohol consumption needs to be individualized and is best undertaken within a clinical context.