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Alcohol and Cardiovascular Health: The Dose Makes the Poison…or the Remedy
Abstract
Habitual light to moderate alcohol intake (up to 1 drink per day for women and 1 or 2 drinks per day for men) is associated with decreased risks for total mortality, coronary artery disease, diabetes mellitus, congestive heart failure, and stroke. However, higher levels of alcohol consumption are associated with increased cardiovascular risk. Indeed, behind only smoking and obesity, excessive alcohol consumption is the third leading cause of premature death in the United States. Heavy alcohol use (1) is one of the most common causes of reversible hypertension, (2) accounts for about one-third of all cases of nonischemic dilated cardiomyopathy, (3) is a frequent cause of atrial fibrillation, and (4) markedly increases risks of stroke-both ischemic and hemorrhagic. The risk-to-benefit ratio of drinking appears higher in younger individuals, who also have higher rates of excessive or binge drinking and more frequently have adverse consequences of acute intoxication (for example, accidents, violence, and social strife). In fact, among males aged 15 to 59 years, alcohol abuse is the leading risk factor for premature death. Of the various drinking patterns, daily low- to moderate-dose alcohol intake, ideally red wine before or during the evening meal, is associated with the strongest reduction in adverse cardiovascular outcomes. Health care professionals should not recommend alcohol to nondrinkers because of the paucity of randomized outcome data and the potential for problem drinking even among individuals at apparently low risk. The findings in this review were based on a literature search of PubMed for the 15-year period 1997 through 2012 using the search terms alcohol, ethanol, cardiovascular disease, coronary artery disease, heart failure, hypertension, stroke, and mortality. Studies were considered if they were deemed to be of high quality, objective, and methodologically sound.
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“The relationship between alcohol use and cardiovascular disease outcomes is complex, as different dimensions play a role for different outcomes 238, 239, 240.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [239]
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“Understanding the impact of alcohol consumption on cardiovascular health requires clear definitions of drinking patterns, as you can see in Table 2 [36].”
BackgroundUdo, T., Vásquez, E., & Shaw, B. A. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.10.008 · Cited by 31
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Nonpharmacologic management of hypertension
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Date Fruits as Raw Material for Vinegar and Non-Alcoholic Fermented Beverages
Cantadori, E., Brugnoli, M., Centola, M., Uffredi, E., Colonello, A., & Gullo, M. (2022) · Foods · doi:10.3390/foods11131972 · Cited by 30
Capítulo 14 – Crise Hipertensiva
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“An increasing body of evidence continues to validate a J- or U-shaped correlation between alcohol consumption and CVD risk factors (Carnevale and Nocella, 2012; Bergmann et al., 2013; Chiva-Blanch et al., 2013; Wakabayashi, 2013a; Klein et al., 2014; Matsumoto et al., 2014; O’Keefe et al., 2014).”
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“associated with numerous positive health outcomes, including lower rates of diabetes mellitus, congestive heart failure, coronary artery disease, stroke, and allcause mortality (71).”
BackgroundDaily alcohol consumption and sickness absence in the GAZEL cohort
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“Wine is often perceived as a relatively healthy alcoholic beverage, and epidemiologic studies have shown the health benefits of moderate wine consumption, including decreased risk of cardiovascular disease-related mortality (O’Keefe et al., 2014).”
The Prognostic Factors of Alcoholic Cardiomyopathy
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Research trends and hotspots of post-stroke cognitive impairment: a bibliometric analysis
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“Notably, habitual mild-to-moderate alcohol consumption has been linked to reduce the risk, while higher levels of alcohol consumption increase the stroke risk (O’Keefe et al., 2014).”
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“Finally, a full understanding of the beneficial effects of ethanol on C. elegansmay provide insights into how consuming small amounts of ethanol may be beneficial to humans (O'Keefe et al., 2014).”
BackgroundInfluentialAlcohol Use and Breast Cancer Survival among Participants in the Women's Health Initiative
Lowry, S., Kapphahn, K., Chlebowski, R. T., & Li, C. I. (2016) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-16-0151 · Cited by 25
“Alcohol has been shown to have a protective effect on cardiovascular disease (CVD) mortality (12), but presumably this effect is not immediate.”
BackgroundResult“The Bottle Is My Wife”: Exploring Reasons Why Men Drink Alcohol in Ugandan Fishing Communities
Breuer, C., Bloom, B. E., Miller, A. P., Kigozi, G., Nakyanjo, N., Ddaaki, W. G., Nalugoda, F. K., & Wagman, J. A. (2019) · Social Work in Public Health · doi:10.1080/19371918.2019.1666072 · Cited by 24
Increased Mortality in Hip Fracture Patients Living Alone: A NOREPOS Study
Dahl, C., Holvik, K., Meyer, H. E., Stigum, H., Solbakken, S. M., Schei, B., Søgaard, A. J., & Omsland, T. K. (2020) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.4212 · Cited by 24
“(46) A high alcohol intake may also be associated with a higher degree of comorbidity, (47) and in the current study the association between living situation and mortality in the youngest male hip fracture patients (50-59 years) was somewhat attenuated when adjusting for comorbidity level.”
BackgroundAlcohol and vascular endothelial function: Biphasic effect highlights the importance of dose
Rajendran, N. K., Liu, W., Cahill, P. A., & Redmond, E. M. (2023) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.15138 · Cited by 23
Metadata
- Authors
- O’Keefe, J. H., Bhatti, S. K., Bajwa, A., DiNicolantonio, J. J., & Lavie, C. J.
- Affiliations
- Saint Luke's Hospital (US)
- The University of Queensland (AU)
- Corresponding author
- O’Keefe, James H.
- Venue
- Mayo Clinic Proceedings
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 89
- Issue
- 3
- Pages
- 382-393
- ISSN
- 0025-6196 (ISSN-L)
- OpenAlex
- W2042273266
- Semantic Scholar
- fb99861a75849bf01ecd526f770d9df083ecff23
- Cited by
- 406
- References
- 96
- Citations by year
- 2026: 20 · 2025: 20 · 2024: 27 · 2023: 41 · 2022: 31 · 2021: 33 · 2020: 43 · 2019: 22 · 2018: 39 · 2017: 35 · 2016: 40 · 2015: 42 · 2014: 13
- FWCI
- 6.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Mayo Clinic Proceedings (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pharmacology (medical) › Coffee research and impacts
- Keywords
- alcohol consumption, cardiovascular health, moderate drinking, heavy drinking, binge drinking, coronary artery disease, stroke, hypertension, congestive heart failure, diabetes mellitus, premature mortality, red wine, atrial fibrillation, non-ischemic dilated cardiomyopathy, risk-benefit ratio
- MeSH terms
- Alcohol Drinking, Ethanol, Alcoholic Beverages, Cardiotonic Agents, Cardiovascular Diseases, Dose-Response Relationship, Drug, Humans, Primary Prevention, Risk Factors, United States, Health Behavior, Secondary Prevention
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