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(Circulation. 2000;102:487.)
© 2000 American Heart Association, Inc.

Editorial

Moderate Alcohol Consumption and Risk of Coronary Heart Disease Among Women With Type 2 Diabetes Mellitus

Timothy J. Regan, MD

From the Department of Medicine, New Jersey Medical School, Newark.

Correspondence to Timothy J. Regan, MD, Division of Cardiology, Department of Medicine, MSB-I 532, UMDNJ-New Jersey Medical school, 185 South Orange Avenue, Newark, NJ 07103. E-mail regantj@umdnj.edu

Key Words: Editorials • coronary disease • myocardial infarction • alcohol • diabetes • pharmacology

For much of the last century, a major medical interest in ethanol research has been related to the biological effects of ethanol abuse on the brain, liver, and heart. Focused in urban centers where addiction to this agent was a common phenomenon, little consideration of the dose-response relationship at the lower end of the scale was provided. Fortunately, there has been a growing interest in this relation over the past 2 to 3 decades.

Epidemiological investigation relying on individual histories of daily intake found that an alcohol intake of 3 to 5 drinks per day was associated with a diminished incidence of myocardial infarction as well as total mortality.¹ a The frequent association with some degree of hypertension was apparently of insufficient impact to affect this beneficial outcome. Most data suggested that this advantage was most evident in those older than 50 years, with some sex differences.

Subsequently, a long-term study from an oncology center pointed out the increased risk of certain cancers associated with alcohol use, independent of tobacco use.¹ b The threshold for an increased appearance of cancer was at the moderate level of 3 to 4 drinks per day in men.¹ b In women, the increased risk for breast cancer seemed to have a threshold of 2 drinks per day.² The term "light drinking" has been used to indicate a level not exceeding 12 to 15 g (1 drink) of ethanol per day.

Major contributions to this field have been made by the Physicians Health Study, which . . . [Full Text of this Article]