Alcohol and the cardiovascular system: molecular mechanisms for beneficial and harmful action

Alcohol can be beneficial or harmful to the cardiovascular system, depending on the amount consumed and the characteristics of the consumer. Of the numerous cellular and molecular mechanisms that are thought to explain the beneficial effects of moderate drinking, this article discusses four, involving (1) high density lipoproteins, (2) cellular signaling, (3) platelet function in blood clot formation, and (4) stimulation of blood clot dissolution. Although light-to-moderate drinking can protect against coronary artery disease, heavy alcohol consumption can damage the cardiovascular system, resulting in maladies such as heart muscle disorders, irregular heart rhythms, high blood pressure, and strokes. This article summarizes representative epidemiological and animal studies on these cardiovascular consequences of chronic heavy alcohol consumption and reviews mechanisms that have been suggested to explain alcohol's effects.

Alcohol Research and Social Policy: An Overview

Science can facilitate the task of choosing among complex social policies, although it rarely serves as the only basis for policy development. Science's role in policy formation can be decisive when public support already exists, as with the passage of the Federal Uniform Drinking Age Act. Science can assess a policy after it has been implemented, as in the scientific evaluation of the health warning labels on alcoholic beverage containers. In addition, science can investigate the short- and long-term benefits and risks of areas where the development of policies is likely. An example is the current scientific examination of the tradeoffs involved in moderate alcohol consumption.

Risks and Benefits of Alcohol Use Over the Life Span

Especially at low and moderate drinking levels, alcohol consumption can be associated with benefits (e.g., protection against coronary heart disease) as well as risks (e.g., increased risk of accidents). These benefits and risks may change across a person's life span. To determine the likely net outcome of alcohol consumption, one must weigh the probable risks and benefits for each drinker. These assessments are based on the individual drinker's consumption levels, his or her personal characteristics (e.g., age or preexisting risk factors for coronary heart disease), and subjective values as well as on social considerations. The validity of such assessments also depends on the accuracy with which alcohol consumption and alcohol-related consequences can be measured.