Wine, beer and spirits and the risk of myocardial infarction: a systematic review

Background: Alcohol has beneficial and harmful effects on health at the same time. Wine may be more beneficial for the heart than other types of alcoholic beverages. Objectives: 1. To assess the current status of knowledge regarding the relationship between death and alcohol consumption. 2. To assess the relationship between myocardial infarction (MI) and consumption of different types of alcoholic beverages, both low doses (1-4 drinks a day), and high doses (> 4 drinks a day). Methods: meta-analysis of major cohort and case-control studies. For the assessment of death and alcohol consumption eight cohort studies were used; for the assessment of MI and different types of alcoholic beverages, 12 cohort and two case-control studies were used. Results and conclusions: 1. Small doses of alcohol (1-4 drinks a day) are associated with a slightly reduced risk of mortality and coronary heart disease (CHD). 2. Small doses (1-4 drinks a day) of wine, beer, and spirits are equally beneficial. 3. Apart from a direct beneficial effect of low doses of alcohol on mortality and CHD, some psychological factors may contribute to its beneficial effect. 4. High doses of alcohol (greater than or equal to 5 drinks a day) are not associated with a reduced risk of death and CHD. 5. Apart from a direct effect of alcohol, confounding factors, particularly those of a psychological nature, may very well again contribute to the loss of benefits. (C) 1999 Editions scientifiques et medicales Elsevier SAS.