Effects of ethanol and other constituents of alcoholic beverages on coronary heart disease: a review

Moderate consumption of alcoholic beverages has been shown to reduce the incidence of coronary artery disease (CAD) compared to abstinence and heavy drinking. Epidemiologic studies suggest that any form of alcoholic beverage offers this protection. However, several studies have shown that the polyphenolic compounds found in many alcoholic beverages are more effective than pure alcohol for improving specific biologic factors known to contribute to atherosclerotic development. The alcoholic beverage polyphenols improve endothelial function, protect LDL from oxidation, inhibit platelet activity, inhibit vascular smooth muscle cell (VSMC) proliferation and migration, and reduce the activation of monocytes in the post-prandial period. Not only does pure alcohol not provide these benefits, but it has also been shown to act as a pro-oxidant, impair endothelial function, and possibly be proinflammatory. In studies comparing red wine, white wine, beer, and liquor, the red wine and dark-colored beer seem to provide more protection than liquor, even though the alcohol contents (per serving) are similar. The results suggest that the type of alcoholic beverage consumed does make a difference because pure alcohol cannot fully account for the beneficial effects.