When the prevention of coronary artery disease (CAD) is discussed, two questions invariably arise concerning alcohol. Does alcohol protect against CAD? If so, how does it do it? The answer to question 1 is yes, and to question 2, we don't know. The topic of alcohol and atherosclerosis has recently been reviewed in some detail, and much of the information on the epidemiology of alcohol and atherosclerosis in this editorial is discussed in greater detail in that review.1
Most of the epidemiologic studies of alcohol and CAD demonstrate that alcohol is protective and that there is an inverse relationship between the amount of alcohol consumed and the risk of developing CAD.1 Four studies are particularly noteworthy because they are well designed and prospective and involve large numbers of subjects.
In the Framingham Heart Study, alcohol consumption, over a range of one to five drinks per day (13 to