Conclusions: The authors concluded that moderate alcohol consumption is associated with lower risk of CHD in men with type 2 diabetes. Results are consistent with those of the four recent studies that focused on the effect of alcohol on the occurrence of fatal or nonfatal myocardial infarction (MI).
Perspective: This is a limited study, and it is not surprising that there is so much confusion about alcohol and cardioprotection.
A. Alcohol and HDL Cholesterol
Several studies have confirmed that alcohol causes a modest increase in high density lipoprotein (HDL) cholesterol levels. There is a clear association between high levels of HDL cholesterol and longevity. Individuals aged 80 and older are often observed to have HDL cholesterol levels >1.8 mmol/L (>70 mg/dl). The major¬ity of individuals aged 30–50 have HDL cholesterol levels between 0.9 to 1.5 mmol/L. The level <0.8 mmol/L [<30 mg/dl] is associated with a high risk for coronary heart disease. No large randomized study, however, has been done to show that if levels of HDL are increased by a drug that this decreases cardiovascular mortality and morbidity.
Moderate consumption of alcohol may cause about a 10–15% increase in HDL cholesterol, and this modest increase is probably cardioprotective but not proven to be so. Moderate consumption of alcohol probably can produce a maximum increase of 20%, but it carries the risk of liver dysfunction, increased blood pressure, worsening heart failure, behavioral disturbances, and in rare instances, damage to the heart muscle. Women, because of their smaller BMI and differences in liver metabolism, should be advised not to exceed one drink a day if benefit is to be obtained without harm.

Страницы: 1 | 2 | 3