Cited by 235Alcohol Consumption and Health EffectsAlcoholism and Thiamine DeficiencySubstance Abuse Treatment and Outcomes

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Alcohol in Moderation, Cardioprotection, and Neuroprotection: Epidemiological Considerations and Mechanistic Studies

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Abstract

In contrast to many years of important research and clinical attention to the pathological effects of alcohol (ethanol) abuse, the past several decades have seen the publication of a number of peer‐reviewed studies indicating the beneficial effects of light‐moderate, nonbinge consumption of varied alcoholic beverages, as well as experimental demonstrations that moderate alcohol exposure can initiate typically cytoprotective mechanisms. A considerable body of epidemiology associates moderate alcohol consumption with significantly reduced risks of coronary heart disease and, albeit currently a less robust relationship, cerebrovascular (ischemic) stroke. Experimental studies with experimental rodent models and cultures (cardiac myocytes, endothelial cells) indicate that moderate alcohol exposure can promote anti‐inflammatory processes involving adenosine receptors, protein kinase C (PKC), nitric oxide synthase, heat shock proteins, and others which could underlie cardioprotection. Also, brain functional comparisons between older moderate alcohol consumers and nondrinkers have received more recent epidemiological study. In over half of nearly 45 reports since the early 1990s, significantly reduced risks of cognitive loss or dementia in moderate, nonbinge consumers of alcohol (wine, beer, liquor) have been observed, whereas increased risk has been seen only in a few studies. Physiological explanations for the apparent CNS benefits of moderate consumption have invoked alcohol’s cardiovascular and/or hematological effects, but there is also experimental evidence that moderate alcohol levels can exert direct “neuroprotective” actions—pertinent are several studies in vivo and rat brain organotypic cultures, in which antecedent or preconditioning exposure to moderate alcohol neuroprotects against ischemia, endotoxin, β‐amyloid, a toxic protein intimately associated with Alzheimer’s, or gp120, the neuroinflammatory HIV‐1 envelope protein. The alcohol‐dependent neuroprotected state appears linked to activation of signal transduction processes potentially involving reactive oxygen species, several key protein kinases, and increased heat shock proteins. Thus to a certain extent, moderate alcohol exposure appears to trigger analogous mild stress‐associated, anti‐inflammatory mechanisms in the heart, vasculature, and brain that tend to promote cellular survival pathways.

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Crossref · 10.1111/j.1530-0277.2008.00828.x

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1 retracted

  • RETRACTED: Redox regulation of resveratrol-mediated switching of death signal into survival signal

    Das, S., Khan, N. I., Mukherjee, S., Bagchi, D., Gurusamy, N., Swartz, H. M., & Das, D. K. (2007) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2007.09.008 · Cited by 46 · cited 2×

    “Whether resveratrol is the essential component that is responsible for much of the cardioprotective effects of wine or the alcohol that is present in wines and is responsible for cardioprotection remains under considerable debate, but there is no doubt that resveratrol may protect the heart in many ways (Das et al., 2…”
    Self-citation
    Retracted
  • The pathogenesis of atherosclerosis: a perspective for the 1990s

    Ross, R. (1993) · Nature · doi:10.1038/362801a0 · Cited by 10,618 · cited 2×

    “In patients with cardiovascular risk factors such as hypercholesterolemia, hypertension, or aging (Zeiher et al., 1993), endothelial dysfunction predisposes to the development of structural vascular changes (Ross, 1993) and may play a critical role in acute MI and sudden death.”
  • Global prevalence of dementia: a Delphi consensus study

    Ferri, C. P., Prince, M. J., Brayne, C., Brodaty, H., Fratiglioni, L., Ganguli, M., Hall, K. S., Hasegawa, K., Hendrie, H. C., Huang, Y., et al. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67889-0 · Cited by 5,336 · cited 2×

    “…that cardiovascular disease and stroke are 2 of the top 3 leading causes of mortality in developed countries and, according to a Lancet review (Ferri et al., 2005), new cases of dementia are being diagnosed about every 7 seconds worldwide, it seems imperative that as much as possible is…”
  • Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors

    Rimm, E. B., Williams, P., Fosher, K., Criqui, M., & Stampfer, M. J. (1999) · BMJ · doi:10.1136/bmj.319.7224.1523 · Cited by 1,360 · cited 17×

    “These include dose-dependent associations of alcohol with lower risk of CHD but higher risk of hemorrhagic stroke throughout a recommended range of drinking, an increased risk of ischemic stroke with heavier drinking, and an emerging but somewhat variable association with lower risk of dementia.”
    Influential
  • Alcohol consumption and mortality among middle-aged and elderly U.S. adults

    Thun, M. J., Peto, R., Lopez, A. D., Monaco, J. H., Henley, S. J., Heath, C. W., & Doll, R. (1997) · New England Journal of Medicine · doi:10.1056/nejm199712113372401 · Cited by 1,313 · cited 2×

    “Heavy alcohol consumption has long been associated with vascular as well as myocardial complications (Klatsky, 1996), whereas, as discussed earlier in this summary, several epidemiological studies suggest an inverse association between longterm moderate alcohol consumption and the risk of CHD and MI (Thun et al., 1997…”
  • ‘Ischemic tolerance’ phenomenon found in the brain

    Kitagawa, K., Matsumoto, M., Tagaya, M., Hata, R., Ueda, H., Niinobe, M., Handa, N., Fukunaga, R., Kimura, K., Mikoshiba, K., et al. (1990) · Brain Research · doi:10.1016/0006-8993(90)90189-i · Cited by 1,090 · cited 2×

    “Ischemic or hyperthermic PC and brain neuroprotection, first described only about 2 decades ago (Chopp et al., 1989; Kitagawa et al., 1990), has spawned studies with traditionally toxic agents at exposures that mildly stress and thus precondition the system under study (Best et al., 1996; Leak et…”
  • Alcohol Consumption and Risk of Stroke

    Reynolds, K., Lewis, B. L., Nolen, J. D. L., Kinney, G. L., Sathya, B., & He, J. (2003) · JAMA · doi:10.1001/jama.289.5.579 · Cited by 927 · cited 1×

    “Meta-analyses of alcohol and stroke support this fully (Reynolds et al., 2003), suggesting 20% lower risk of ischemic stroke among lessthan-daily drinkers in cohort studies, but increased risk with heavier drinking, and a dose-dependent increase in risk for hemorrhagic stroke.”
  • Alcohol and coronary heart disease: a meta-analysis.

    Corrao, G., Rubbiati, L., Bagnardi, V., Zambon, A., & Poikolainen, K. (2000) · Addiction · doi:10.1046/j.1360-0443.2000.951015056.x · Cited by 875 · cited 2×

    “…conclusions about the relationship of average alcohol consumption with risk, suggesting 25% lower risk throughout a range of intake from about ½ drink per day through 2 drinks per day, but potentially higher risk at or above 6 drinks per day (Cleophas, 1999; Corrao et al., 2000; Maclure, 1993).”
  • Roles of Drinking Pattern and Type of Alcohol Consumed in Coronary Heart Disease in Men

    Mukamal, K. J., Conigrave, K. M., Mittleman, M. A., Camargo, C. A., Stampfer, M. J., Willett, W. C., & Rimm, E. B. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa022095 · Cited by 811 · cited 9×

    “In the CHS and HPFS, alcohol intake correlates well with HDL-C levels, with coefficients of 0.25 to 0.35.”
    InfluentialSelf-citation
  • Ischemic tolerance and endogenous neuroprotection

    Dirnagl, U., Simon, R. P., & Hallenbeck, J. M. (2003) · Trends in Neurosciences · doi:10.1016/s0166-2236(03)00071-7 · Cited by 791 · cited 1×

    “Studies with more common PC modalities—in particular, ischemic tolerance—have elucidated the involvement of early cellular ‘‘sensors’’ that trigger subsequent ‘‘transducer’’ mechanisms such as kinases, cytokines, and transcription factors upstream of hsp effectors (Dirnagl et al., 2003).”

Show all 128 references

Research works printed but not linked: 4

  1. Korthuis RJ, 2004, Alcohol and cardioprotection, Pathophysiology, 10, 1
  2. Mitchell RM, 2007, Neuroprotection by moderate ethanol preconditioning: Involvement of NMDA receptor signaling, Alcohol Clin Exp Res, 31, 196A
  3. Sivaswamy S, 2008, PKC and focal adhesion kinase (FAK): possible transducer roles in ethanol preconditioning‐induced neuroprotection from HIV‐1 gp120, J Neurochem, 104, 32
  4. Zhou HZ, 2004, Moderate ethanol consumption improves mitochondrial function and cardiac energetics during oxidative stress: roles of PKCepsilon and Akt, Circulation, 110, 111

Cited by

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Items 201–235 of 235

Metadata

Authors
Collins, M. A., Neafsey, E. J., Mukamal, K. J., Gray, M. O., Parks, D. A., Das, D. K., & Korthuis, R. J.
Affiliations
San Francisco General Hospital (US)
Venue
Alcoholism: Clinical and Experimental Research
Publisher
Wiley
Published
2009-01-22
Volume
33
Issue
2
Pages
206-219
ISSN
  • 0145-6008 (ISSN-L)
  • 1530-0277
OpenAlex
W2111348890
Cited by
235
References
128
Citations by year
2026: 7 · 2025: 7 · 2024: 8 · 2023: 5 · 2022: 11 · 2021: 7 · 2020: 9 · 2019: 16 · 2018: 9 · 2017: 13 · 2016: 14 · 2015: 11 · 2014: 17 · 2013: 24 · 2012: 16
FWCI
2.38
Type
journal article
Language
en
Open access
Locations
  • Alcoholism Clinical and Experimental Research (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5r01aa011723-03)
  • National Institute on Alcohol Abuse and Alcoholism (R01AA013568, AA 11135, AA014945, R01AA011135, R01AA014945, AA013568, AA 13361, AA 011723, F31AA013361)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P01DK043785)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Clinical Neurology › Alcoholism and Thiamine Deficiency
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
moderate drinking, cardioprotection, neuroprotection, coronary artery disease, ischemic stroke, dementia, cognitive decline, anti-inflammatory mechanism, adenosine receptors, protein kinase C, nitric oxide synthase, heat shock proteins, cerebral ischemia, amyloid-beta, gp120, reactive oxygen species, signal transduction
MeSH terms
Resveratrol, Alcohol Drinking, Ethanol, Animals, Antioxidants, Cardiotonic Agents, Cardiovascular Diseases, Central Nervous System Depressants, Dementia, Humans, Nitric Oxide, Protein Kinase C, Stilbenes, Neuroprotective Agents

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