Studies on the association between alcohol and high density lipoprotein cholesterol: possible benefits and risks.

The weight of the evidence suggests a positive relationship between alcohol consumption and HDLc. The relationship showed a linear dose response relationship with HDLc over the range of alcohol consumption from non-drinkers to alcoholics. The effect appears to be reversible since changes in alcohol intake result in changes in HDLc. Preliminary evidence has suggested that in alcoholics, the effect may primarily be on the HDL-2 subfraction, while in the general population, it may primarily raise the HDL-3 subfraction. Limited research has shown a positive relationship between alcohol consumption and apo A-I levels. The exact underlying mechanisms for this relationship is not known. It remains to be determined if alcohol also exerts an effect on Coronary Heart Disease that is independent of its effect on HDLc. It is important to further evaluate these important leads both because it may provide a better understanding of the relationship between HDL, lipoprotein metabolism and coronary artery disease and the role of alcohol in the genesis of heart disease. A public health recommendation to increase alcohol consumption to reduce risk of heart attack is not indicated. Cessation of moderate alcohol consumption, however, should also not be part of the current recommendation to improve lipoprotein profiles.