Is the cardioprotective effect of alcohol real?

A large number of investigations in experimental, clinical, and epidemiological settings have given support to the idea that consumption of moderate amounts of alcoholic beverages, particularly wine, protects against coronary heart disease (CHD). Biological effects of other components of wine in human beings, however, have been hardly demonstrated, and alcohol itself has several potential adverse effects on the cardiovascular system. Not all epidemiological surveys have found protection from alcoholic beverages and in African-Americans, alcohol consumption was a risk factor for the incidence of CHD. The possibility that the lower risk of drinkers of moderate amounts of wine or other beverages is secondary to a health cohort effect in whites is not negligible, and could be discarded only in a clinical trial. In view of the potential risks of alcohol, a more cautious view about the beneficial effects of alcoholic beverages is warranted.