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International Journal of Epidemiology 2001;30:739-742
© International Epidemiological Association 2001

Special theme: Alcohol: Reiteration

Commentary: Could abstinence from alcohol be hazardous to your health?

AL Klatsky

Kaiser Permanente Medical Center, 280 West MacArthur Boulevard, Oakland, CA D4611, USA. E-mail: hartmavn@pacbell.net

The first 150 words of the full text of this article appear below.

‘Those who cannot remember the past are condemned to repeat it.’

George Santayana 1905

William Heberden's classic description of angina pectoris in 17861 included: ‘Wine and spirituous liquors ... afford considerable relief’. This observation, plus the cutaneous facial vasodilatation often induced by alcohol, led to the presumption by some observers that alcohol was a coronary vasodilator.2,3 However, exercise ECG test data4,5 suggested only subjective symptomatic benefit and indicated no acute increase in myocardial oxygenation from alcohol. Thus, angina relief may be due to an anaesthetic effect of alcohol. Physiological studies do not convincingly establish a major immediate effect of alcohol upon coronary blood flow.6,7 In any case, angina is subjective, difficult to measure, and has been relatively little used as an endpoint in epidemiological studies of alcohol and coronary heart disease (CHD).

In the first half of the 20th century there were reports of an apparent inverse relationship between heavy . . . [Full Text of this Article]

Does heavy alcohol consumption increase CHD risk?

Does moderate alcohol consumption protect against CHD?

Is the lower CHD risk due to factors other than alcohol?

How might alcohol protect against CHD?

Is the negative association causal?

What recommendations should be made?


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