4

I’ve heard this claim from several people in Ukraine: people who die of alcoholism tend to have little trace of atherosclerosis (fatty deposits which lead to heart attacks and strokes) in their veins.

(obviously this doesn’t help people who want to prevent atherosclerosis in order to live longer, but nevertheless an interesting result if true)

3

No. But moderate alcohol consumption seems to have some good effects.

The association between regular alcohol intake and incident carotid atherosclerosis (early atherogenesis) was J-shaped, with light drinkers facing a lower risk than either heavy drinkers or abstainers. Protection offered by alcohol consumption of <50 g/d appeared to act through inhibition of the injurious action of high levels of low-density lipoprotein (LDL) cholesterol [1].

This is sustained by epidemiologic data, however the mechanism remains unclear:

Epidemiologic data generally show an inverse correlation between coronary heart disease risk and moderate alcohol intake (variously defined but generally corresponding to 2 to 4 drinks per day). ... The mechanism by which moderate alcohol intake "protects" remains unclear. Perhaps the best available hypothesis relates to the increased concentration of high-density lipoprotein (HDL) cholesterol associated with moderate alcohol intake. However, it should be stressed that we are still uncertain about the mechanisms linking a high HDL level to protection against coronary heart disease. If a high HDL level is only a marker (and not directly protective), raising HDL levels need not confer protection. Alcoholism, on the other hand, is associated with marked elevation of triglyceride-rich lipoproteins and is among the most common causes of hypertriglyceridemia [2].

So it increases blood triglycerides. And it is also a risk factor for hypertension:

There was an increased risk of hypertension in those who consumed large amounts of ethanol (>/=210 g per week) compared with those who did not consume alcohol over the 6 years of follow-up [3].

Although moderate alcohol consumption may protect against atherosclerosis, it promotes other cardiovascular diseases. Other factors should be taken into account too:

The robust relationship between moderate drinking and lower risk of cardiovascular disease remains an intriguing area of investigation. ... Moderate alcohol use also has important inverse relations with inflammatory factors. ... The non-alcoholic constituents of red wine also have anti-atherogenic and perhaps even life-extending properties in vitro, but their relevance to humans remains uncertain. Genetic variants of the apolipoprotein E and interleukin 6 genes in humans may modify how alcohol influences atherosclerosis [4].


References:

  1. Kiechl S, Willeit J, Rungger G, Egger G, Oberhollenzer F, Bonora E. Alcohol consumption and atherosclerosis: what is the relation? Prospective results from the Bruneck Study. Stroke. 1998 May;29(5):900-7. PubMed PMID: 9596232.
  2. Steinberg D, Pearson TA, Kuller LH. Alcohol and atherosclerosis. Ann. Intern. Med. 1991 Jun 1;114(11):967-76. PubMed PMID: 2024865.
  3. Fuchs FD, Chambless LE, Whelton PK, Nieto FJ, Heiss G. Alcohol consumption and the incidence of hypertension: The Atherosclerosis Risk in Communities Study. Hypertension. 2001 May;37(5):1242-50. PubMed PMID: 11358935.
  4. Li JM, Mukamal KJ. An update on alcohol and atherosclerosis. Curr. Opin. Lipidol. 2004 Dec;15(6):673-80. PubMed PMID: 15529027.

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