There have been thousands of basic science studies showing that administering alcohol or wine to laboratory animals results in beneficial effects on the risk of atherosclerosis and heart disease. The present excellent paper summarizes what are now a large number of human trials testing whether wine and/or alcohol have the same effects on reducing risk factors for CVD. There have not yet been randomized clinical trials to evaluate the effects of alcohol administration on cardiovascular outcomes such as myocardial infarction, cardiac death, or other cardiovascular diseases (CVD) in humans. It is unlikely that such studies will be done because of the long time of follow up required, the huge cost, and the difficulties in getting a very large number of people randomly assigned to agree to consume a specified amount of alcohol, or agree to avoid all alcohol, for many years. For these lifestyle habits, we must use our best judgment based on carefully done observational studies, research into potential mechanisms of effect, and studies of intermediate outcomes that are in pathways and processes in the development of the disease.
The second paper (Reference: Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ 2011;342:d671; doi:10.1136/bmj.d671 ) looked at cohort studies on the association between alcohol consumption and overall mortality from cardiovascular disease, incidence of and mortality from coronary heart disease, and incidence of and mortality from stroke. 4,235 studies were reviewed for eligibility, quality and data extraction, 84 were included in the final analysis.
Dose-response analysis revealed that the lowest risk of coronary heart disease mortality occurred with 1 drinks a day, but for stroke mortality it occurred with =1 drink per day. Secondary analysis of
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Boston University Medical Center