The DOI matches its Crossref record; 128 of the 128 references it cites were found in a registry or an index.
Alcohol in Moderation, Cardioprotection, and Neuroprotection: Epidemiological Considerations and Mechanistic Studies
Open accessAbstract
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.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“a protective effect of light to moderate drinking has some biological plausibility 212, but evidence on this is inconsistent.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [212]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
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-citationRetractedThe 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…”
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.”
InfluentialAlcohol 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-citationIschemic 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).”
Research works printed but not linked: 4
- Korthuis RJ, 2004, Alcohol and cardioprotection, Pathophysiology, 10, 1
- Mitchell RM, 2007, Neuroprotection by moderate ethanol preconditioning: Involvement of NMDA receptor signaling, Alcohol Clin Exp Res, 31, 196A
- 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
- 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
Sorted by citations
Items 201–235 of 235
Relationship between Wine Consumption and Alzheimer's DiseasePreprint
Reale, M., D’Angelo, C., Costantini, E., Jagarlapoodi, S., Khan, H. Z., Belwal, T., & Cichelli, A. (2019) · Preprints.org · doi:10.20944/preprints201911.0060.v1 · Cited by 1
“, in their study, reported that the modifications of alcohol-related anti-inflammatory heat shock protein and protein kinase in the brain have similarities with those observed in the heart [34].”
BackgroundHorvat, P. (2014) · UCL Discovery (University College London)
Health consequences of alcohol intake.
Buglass, A. J. (2011)
Virta, J. J. (2012) · UTUPub (University of Turku)
French Paradox, Polyphenols and Cardiovascular Protection: The Oestrogenic Receptor-α Implication
Benaissa, T., Ragot, T., & Tesse, A. (2012) · InTech eBooks · doi:10.5772/38208
“Moreover, on the light of other epidemiological data, it seems to be developed the view that modest alcohol but neither zero nor more than modest intake reduces total mortality and cardiovascular risk by cardio and neuroprotection (Collins et al., 2009; Opie and Lecour, 2007).”
The Evolving Global Burden of Disease from Alcohol
Tsoh, J., & Chiu, H. F. K. (2009) · Wiley eBooks · doi:10.1002/9780470975084.ch17
Alcohol prevention in Swedish primary health care
Geirsson, M. (2011) · Gothenburg University Publications Electronic Archive (Gothenburg University)
Animal Models of Lung Injury: Role for Mesenchymal Stem Cells
Rojas, M., Iyer, S. S., Co, C., & Brigham, K. L. (2010) · Humana Press eBooks · doi:10.1007/978-1-60761-775-4_8
“Numerous epidemiology and experimental studies have described alcohol’s healthrelated benefits, such as cardio- and neuroprotection when consumed in moderation [ 56 ].”
BackgroundAlcohol consumption in relation to cardiovascular risk and mortality
Costanzo, S. (2012) · Research Publications (Maastricht University) · doi:10.26481/dis.20120126sc
Lorkiewicz, S. A. (2015) · OpenBU (Boston University)
Mumpi, B. E. (2015) · University of the Witwatersrand, Johannesburg Institutional Repository on DSpace (University of the Witwatersrand, Johannesburg)
Effects of Alcohol on Cardiovascular Disease Risk
Ellison, R. C. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4377-1366-4.00018-4
Mattingly, M., Osborn, K. E., & Prockop, L. D. (2016) · doi:10.1002/9781118797662.ch11
Chapter 17Neurological Disorders
Trevathan, E. (2010) · American Public Health Association eBooks · doi:10.2105/9780875531922ch17
Brenner, D. R., Haig, T. R., Poirier, A. E., Akawung, A. K., Friedenreich, C. M., & Robson, P. J. (2017) · Promotion de la santé et prévention des maladies chroniques au Canada · doi:10.24095/hpcdp.37.12.03f
“< 0,0001 Fumeur (quotidien ou occasionnel) 189 (14,1) 486 (14,6) 451 (16,7) 312 (20,2) 107 (24,7) 283 (37,3)”
BackgroundInfluentialUpdated Information on Some Cognitive Disorders
Sibat, H. F., & Valdés, L. D. F. I. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.81826
“Ethanol also increases insulin sensitivity [177], prevents platelet aggregation [178], increases fibrinolysis [179], opposes thrombin activity [180], and reduces inflammatory markers such as plasma C-reactive protein and fibrinogen levels [181].”
BackgroundDíaz, M. L., Casañas‐Sánchez, V., Quinto‐Alemany, D., & Pérez, J. A. P. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-813125-1.00048-9
Tratamento da demência vascular
Brucki, S. M. D., Ferraz, A. C., de Freitas, G. R., Massaro, A. R., Radanovic, M., & Schultz, R. R. (2011) · Redalyc (Universidad Autónoma del Estado de México)
Association between physical activity and Alzheimer\'s disease
Stephen, R. (2014) · UEF eRepo (University of Eastern Finland)
Heart failure in children and adolescents (high yield topics for primary care pediatrician)
Delyagin, W. M., & Lukyanova, I. V. (2021) · Pediatrics Consilium Medicum · doi:10.26442/26586630.2021.3.200998
Health Consequences of Alcohol Intake
Buglass, A. J. (2010) · Wiley eBooks · doi:10.1002/9780470976524.ch38
Matsumoto, C. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-801238-3.99607-7
Matsumoto, C. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-809657-4.99607-8
Analysis of Prognostic Factors of Bell’s Palsy in a Tertiary Care Centre of Eastern Nepal
Paudel, D. R., Chettri, S. T., Sah, B., Dahal, R., & Pyakurel, P. (2021) · Kathmandu University Medical Journal · doi:10.3126/kumj.v19i3.49710
A Review on Alcohol Temperance in Health and Disease
Nwokike, M. O., Ogbonna, A. O., Ezenwaeze, M. N., Anusiem, C. A., & Ghasi, S. I. (2022) · Journal of Advances in Medicine and Medical Research · doi:10.9734/jammr/2022/v34i244918
Choi, A., Park, I., You, J. S., Chung, S. P., & Park, Y. S. (2025) · Journal of Korean Medical Science · doi:10.3346/jkms.2025.40.e96
“33 The neuroprotective state associated with alcohol intake may involve the activation of signal transduction pathways, potentially involving reactive oxygen species, essential protein kinases, and increased expression of heat shock proteins.”
Dorey, J., & Menecier, P. (2025) · Psychotropes · doi:10.3917/psyt.312.0023
Alcohol use as a potential moderator of risk factors for Alzheimer's disease
Stelmokas, J. (2013) · CommonKnowledge Research Repository (Pacific University Oregon)
Increased alcohol drinking and seizure susceptibility in female humanized ApoE4 knockin rats
Choi, C. Y., Venegas, J. J., Rauch, S. M., Walter, F. A., Ryan, J. N., Machireddy, M., Weisz, J. M., Tracy, G., Baker, A. J., Floresco, S., et al. (2026) · Physiology & Behavior · doi:10.1016/j.physbeh.2026.115308
de Souza, N. S., Cotrim, H. P., & de Andrade, A. R. C. F. (2026) · BMC Gastroenterology · doi:10.1186/s12876-026-04814-5
“The presumed cardioprotective effect of light alcohol consumption has been attributed to improvements in lipid profile (increased HDL and reduced oxidized LDL), decreased platelet aggregation, and enhanced insulin sensitivity [30].”
Assessment of the Potential Impact of Aqueous and Ethanolic Malt Extracts on HepG2 Liver Cells
Santos, D. L. P., Pereira, M. J., Jesus, A. M. C., Oliveira, R. F., Oliveira, A. I., & Pinho, C. (2026) · Food Technology and Biotechnology · doi:10.17113/ftb.64.03.26.9286
“…antioxidant capacity, neuroprotective properties, improved lipid profile, reduced risk of atherosclerosis and decreased inflammatory markers [ 12 , 13 ], excessive beer consumption is associated with hepatotoxicity, which can lead to hepatic steatosis, alcoholic hepatitis, fibrosis and cirrhosis…”
Ferulic acid: An antioxidant with implications in health and disease prevention
Yadav, A., Verma, H., Yadav, B., Rao, R., Kumari, S., Arora, J., Kumari, K., Gangwar, P., Josan, H., Patidar, V., et al. (2026) · Beer in Health and Disease Prevention · doi:10.1016/b978-0-443-22332-7.00049-0
Trius‐Soler, M., Guasch‐Ferré, M., Valle‐Hita, C., Jensen, M., & Tolstrup, J. S. (2026) · European Journal of Public Health · doi:10.1093/eurpub/ckag162
“…and CHD risk in Japanese males without coronary artery calcification burden [32], suggesting that the positive associations may involve non-atherosclerotic pathways, such as platelet aggregation [33, 34], endothelial function [35], inflammation [36], or myocyte resistance to ischemic injury [31].”
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
- PMC
- PMC2908373
- 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
- green
- www.ncbi.nlm.nih.gov
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review