"Alcohol consumption increases the risk of CVD(20). In the Global Action Plan for Prevention and Control of NCDs, the World Health Organization (WHO) calls for a 10% relative reduction in the per capita use of alcohol between 2013- 2030 (21). Based on recent evidence, it has been concluded that there is “no safe level of alcohol consumption”(5). Risks attributable to alcohol use increase for all the major categories of CVD(20). Thus, alcohol increases the risk for hypertensive heart disease, cardiomyopathy, atrial fibrillation and flutter, and strokes. In moderate drinkers, the risk of stroke is 1.14 times greater (95% CI, 1.10-1.17); coronary disease (excluding myocardial infarction) is 1.06 (95% CI, 1.00 – 1.11); heart failure is 1.09 (95% CI, 1.03- 1.15); fatal hypertensive disease 1.24 (95% CI, 1.15-1.33) and fatal aortic aneurysm is 1.15 times greater (95% CI, 1.03-1.28)(20) than for non-drinkers. It has been argued that people with moderate consumption and no binge episodes may appear to have a slightly lower risk of ischaemic heart disease (IHD), but the protective effect of moderate alcohol consumption for IHD has been challenged as the evidence is based entirely upon non-randomized studies(22)"

An increase in high-density lipo-protein (HDL) cholesterol has been the most compelling potential source of biologic plausibility for how alcohol might help prevent CVD. However, the cardioprotective effect of HDL is under challenge: many studies find no effect from increased HDL levels on reducing the risk for myocardial infarction(23)(24)(25). Other proposed cardioprotective biological mechanisms have also been shown to be inconsistent with sound epidemiologic studies. These include coronary calcification and carotid intima-media thickness, where alcohol consumption is associated with worse vascular health(26)(27). Contrary to popular opinion, alcohol is not good for the heart. This directly contradicts the common message over the past three decades from some researchers, the alcohol industry, and the media that alcohol prolongs life, chiefly by reducing the risk of CVD. For example, the use of red wine has been promoted through various diets as a “heart-healthy” beverage for the longest time. The presence of resveratrol in wine has been known for its cardioprotective characteristics in light to moderate drinkers. However, there are multiple reasons that the belief that alcohol is good for cardiovascular health is no longer acceptable:

• Such evidence has been based on observational studies • No randomized controlled trials (RCTs) have confirmed health benefits of alcohol • The presence of unaccounted confounding factors further weakens the quality of evidence • Studies misclassify unhealthy ex-drinkers as abstainers • Most evidence is observed only in the Caucasian population • Studies that show positive effects are funded by the alcohol industry.* Research in the latest decade has led to major reversals in the perception of alcohol in relation to health in general and CVD in particular. These developments have prompted health authorities in a number of countries, e.g. the Netherlands(28), England(29) and Australia(30), to lower their recommended amount of alcohol for low-risk drinking. The alcohol industry has also perpetuated misleading information about the benefits of drinking alcohol. This interference by the alcohol industry closely reflects the universally vilified activities of tobacco companies. Alcohol industries deceptively promote their products under the labels of “healthy” and “safe”. Portrayal of alcohol in print and electronic media as necessary for a vibrant social life has diverted attention from the harms of alcohol use. Youth-targeted advertisement and encouraging alcohol as “heart-healthy” have created a conducive environment for young adults to relate alcohol with ‘having a good time’. Contrary to this belief, evidence from all around the world exists to link alcohol with a range of noncommunicable and infectious diseases."

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