Vascular and Biochemical Effects of Moderate Alcohol Consumption: Mechanisms of Protection Against Cardiovascular Disease

© 2004 Elsevier Ltd. All rights reserved. This chapter focuses on the vascular and biochemical effects of moderate alcohol consumption and the mechanisms of protection against cardiovascular disease. Cardiovascular disease (CVD), including coronary heart disease, cerebrovascular disease, and peripheral vascular disease, is the leading cause of morbidity and mortality in the Western world. Atherosclerosis, a process of thickening and hardening of the arterial wall, is the underlying cause of CVD. Epidemiological and clinical studies suggest that moderate alcohol consumption may reduce the risk of CVD. Cross-sectional data suggest that moderate alcohol consumers have improved arterial elasticity, which to some extend may contribute to a lower CVD risk. There are additional important biological effects of moderate alcohol consumption which may help explain to its impact on vascular health. The alcohol-induced increase in high- density lipoprotein-cholesterol and its associated functions may affect both the construction/synthesis and the degradation of the atherosclerotic plaque. The reduction of inflammatory factors with moderate alcohol intake could affect the initiation and progression of an atherosclerotic lesion. The effect of moderate alcohol intake on insulin sensitivity, possibly modulated by adiponectin, might indirectly reduce the risk of CVD.