The positive relationship between alcohol and heart disease in eastern Europe: potential physiological mechanisms
Open accessAbstract
Research into the effect of alcohol on cardiovascular disease has indicated protective effects from moderate consumption. These observations, made in industrialized countries, have influenced policies on alcohol in countries where the situation may be quite different—specifically, where consumption is substantially higher or patterns of drinking are different. In central and eastern Europe and the former Soviet Union, a growing body of epidemiological research indicates a positive rather than negative association between alcohol consumption and cardiovascular deaths, especially sudden cardiac deaths. By means of a systematic review of published work, we examine whether there is a physiological basis for the observed association between alcohol and heart disease seen in eastern Europe, focusing on the effects of high levels of consumption and of irregular or binge drinking. In binge drinkers, cardioprotective changes in high-density lipoproteins are not seen, and adverse changes in low-density lipoproteins are acquired. Irregular drinking is associated with an increased risk of thrombosis, occurring after cessation of drinking. It predisposes both to histological changes in the myocardium and conducting system and to a reduction in the threshold for ventricular fibrillation. Measures of frequency as well as quantity of consumption should be included in epidemiological studies. Taken with the epidemiological evidence emerging from eastern Europe, these observations have important implications for estimates of the burden of disease attributable to alcohol.
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Irregular heavy drinking has effects on clotting, increasing the risk of thrombosis.
“Secondly, there are effects on clotting, increasing the risk of thrombosis.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [253]
For the effects of irregular heavy drinking occasions on cardiovascular disease, there are potentially four main mechanisms.
“For the effects of irregular heavy drinking occasions on cardiovascular disease, there are potentially four main mechanisms 253.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [253]
Irregular heavy drinking increases the risk of coronary artery disease via unfavourable impacts on blood lipids.
“First, irregular heavy drinking increases the risk of coronary artery disease via unfavourable impacts on blood lipids.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [253]
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- Authors
- Mckee, M., & Britton, A.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Venue
- Journal of the Royal Society of Medicine
- Publisher
- SAGE Publications
- Published
- 1998-08
- Volume
- 91
- Issue
- 8
- Pages
- 402-407
- ISSN
- 0141-0768 (ISSN-L)
- 1758-1095
- PMC
- PMC1296837
- OpenAlex
- W1858219627
- Cited by
- 264
- References
- 50
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 8 · 2020: 1 · 2019: 5 · 2018: 2 · 2017: 10 · 2016: 4 · 2015: 4 · 2014: 20 · 2013: 13 · 2012: 19
- FWCI
- 8.14
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of the Royal Society of Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- 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 › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- alcohol consumption, cardiovascular disease, sudden cardiac death, binge drinking, high-density lipoprotein, low-density lipoprotein, thrombosis, myocardial histology, cardiac conduction system, ventricular fibrillation, former Soviet Union, Eastern Europe, alcohol policy, disease burden
- MeSH terms
- Alcohol Drinking, Ethanol, Arrhythmias, Cardiac, Blood Coagulation, Cardiovascular Diseases, Europe, Eastern, Humans, Lipoproteins
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