This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Freiberg, M. S. Articles by Samet, J. H. Search for Related Content PubMed PubMed Citation Articles by Freiberg, M. S. Articles by Samet, J. H. Related Collections Acute myocardial infarction Related Article

(Circulation. 2005;112:1379-1381.)
© 2005 American Heart Association, Inc.

Editorial

Alcohol and Coronary Heart Disease

The Answer Awaits a Randomized Controlled Trial

Matthew S. Freiberg, MD, MSc; Jeffrey H. Samet, MD, MPH

From the Division of General Internal Medicine, Center for Research on Health Care, Departments of Medicine and Epidemiology, University of Pittsburgh Schools of Medicine and Public Health, Pittsburgh, Pa (M.S.F.), and the Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, Mass (J.H.S.).

Correspondence to Matthew S. Freiberg, MD, MSc, Division of General Internal Medicine, Center for Research on Health Care, University of Pittsburgh Medical Center, 230 McKee Pl, Suite 600, Pittsburgh, PA 15213. E-mail freibergms@upmc.edu

Key Words: Editorials • alcohol • myocardial infarction • coronary disease • therapy

An extract of the first 250 words of the full text is provided, because this article has no abstract.

In this issue of Circulation, Mukamal and colleagues report that frequent moderate consumption of alcohol is inversely associated with incident myocardial infarctions for both men and women.¹ This finding is consistent with numerous studies conducted in the course of 3 decades that have documented this inverse relationship. It has been described as a "J-" or "U-" shaped phenomenon, with moderate drinkers having a lower risk of myocardial infarctions as compared with abstainers and heavy drinkers.² A substantial contribution of this study is the results suggesting that the observed "benefits" of alcohol on myocardial infarction outcomes, particularly in men, are mediated in large part by only 3 factors: HDL-cholesterol, glucose intolerance (HbA_1C), and fibrinogen.

See p 1406

Previous studies have examined the potential causes for the observed benefits of moderate alcohol consumption and are consistent with these findings. Serum HDL-cholesterol concentrations, for example, increase in a dose-dependent response to alcohol consumption.³ Prospective studies have reported a reduced incidence of type 2 diabetes mellitus⁴ and 1 randomized controlled trial showed increased insulin sensitivity levels with moderate alcohol consumption.⁵ Heavy drinking and binge drinking have been associated with an increased incidence of type 2 diabetes.⁶ Similarly, moderate alcohol consumption is associated with lower levels of inflammatory and hemostatic markers as compared with never or occasional consumption.^7,8 Heavy alcohol drinkers, in contrast, have higher levels of the inflammatory marker C-reactive protein, as compared with moderate drinkers.⁸ Even when risk factors are examined in aggregate, as in the case of the metabolic syndrome, . . . [Full Text of this Article]

Related Article:

Drinking Frequency, Mediating Biomarkers, and Risk of Myocardial Infarction in Women and Men

Kenneth J. Mukamal, Majken K. Jensen, Morten Grønbæk, Meir J. Stampfer, JoAnn E. Manson, Tobias Pischon, and Eric B. Rimm
Circulation 2005 112: 1406-1413. [Abstract] [Full Text]

This article has been cited by other articles:

				K. Herttua, P. Makela, and P. Martikainen An evaluation of the impact of a large reduction in alcohol prices on alcohol-related and all-cause mortality: time series analysis of a population-based natural experiment Int. J. Epidemiol., December 7, 2009; (2009) dyp336v1. [Abstract] [Full Text] [PDF]

				I. Janszky, R. Ljung, S. Ahnve, J. Hallqvist, A. M. Bennet, and K. J. Mukamal Alcohol and long-term prognosis after a first acute myocardial infarction: the SHEEP study Eur. Heart J., January 1, 2008; 29(1): 45 - 53. [Abstract] [Full Text] [PDF]

				I. Shai, J. Wainstein, I. Harman-Boehm, I. Raz, D. Fraser, A. Rudich, and M. J. Stampfer Glycemic Effects of Moderate Alcohol Intake Among Patients With Type 2 Diabetes: A multicenter, randomized, clinical intervention trial Diabetes Care, December 1, 2007; 30(12): 3011 - 3016. [Abstract] [Full Text] [PDF]

				J. H. O'Keefe, K. A. Bybee, and C. J. Lavie Alcohol and Cardiovascular Health: The Razor-Sharp Double-Edged Sword J. Am. Coll. Cardiol., September 11, 2007; 50(11): 1009 - 1014. [Abstract] [Full Text] [PDF]

				R. A. Kloner and S. H. Rezkalla To Drink or Not to Drink? That Is the Question Circulation, September 11, 2007; 116(11): 1306 - 1317. [Abstract] [Full Text] [PDF]

				L. H. Opie and S. Lecour The red wine hypothesis: from concepts to protective signalling molecules Eur. Heart J., July 2, 2007; 28(14): 1683 - 1693. [Abstract] [Full Text] [PDF]