Alcohol and atherosclerosis

Article Abstract:

Several studies in recent years have suggested that moderate consumption of alcohol (two to four drinks per day) may protect to some degree against heart disease. At least one study found the greatest number of deaths from heart disease occurred among total abstainers and heavy drinkers. Some of the known risk factors for heart disease include high total cholesterol levels, high levels of LDL (low density lipoprotein) one component of total cholesterol, and low levels of HDL (high density lipoprotein). Alcohol seems to modify the body's ability to metabolize cholesterol, and this may contribute to its apparent protectiveness, in that lower cholesterol levels are correlated with lesser degrees of atherosclerosis, or hardening of the arteries. HDL helps to prevent atherosclerosis by removing cholesterol from the walls of the arteries, and moderate drinkers often have higher HDL levels than non-drinkers. Of note, however, is the fact that excessive alcohol consumption is associated with lower HDL levels. How alcohol either promotes or protects against heart disease is complicated by a number of factors. For example, many heavy alcohol users are heavy smokers, which certainly increases risk, but alcohol might constitute 40 to 60 percent of the total caloric intake of some heavy drinkers, reducing the amount of fatty foods that they are eating, which decreases risk. Given the risks of alcohol toxicity from heavy drinking, the effects of binge drinking, and drinking during pregnancy, along with the tremendous potential for abuse that alcohol has as an addictive drug, despite its apparent protective effect, doctors should not yet be prescribing a drink or more a day as preventive medicine. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Coronary heart disease, Alcohol, Ethanol, Cholesterol, Lipoproteins, panel discussion

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Guidelines for the detection and treatment of elevated serum cholesterol: which is the baby and which is the bathwater?

Article Abstract:

The role of cholesterol in heart disease has been receiving widespread medical and media attention in recent years. High blood levels of cholesterol do increase the rate of hardening of the arteries, or atherosclerosis, and studies have shown (in white men) that reducing the blood levels of cholesterol can reduce death from heart disease. Other studies have shown that the overall death rate among people being treated for high cholesterol is not reduced, provoking speculation that low blood cholesterol levels are associated with other illnesses. Further analysis has demonstrated that most of the diseases from which the treated patients were dying caused low cholesterol. Still other studies suggest that strategies to lower blood cholesterol will cost large sums of money, and add few meaningful years of life to those treated. Most of these studies are statistical analyses and not clinical trials. Most clinical studies were not designed to determine if lowering blood levels of cholesterol reduces mortality. The National Cholesterol Education Program Expert Panel in the Detection, Evaluation, and Treatment of High Blood Cholesterol has offered dietary recommendations originally aimed at reducing blood cholesterol levels in those at risk for heart disease, but these dietary standards are now believed to be correct for the population in general. They include the suggestion that no more than 30 percent of the daily calorie intake be from fat, and that the amount of cholesterol consumed in a given day be less than 300 milligrams. Therapy for high blood cholesterol should not be based on population-wide studies, but be tailored to the needs and lifestyle of the individual patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Research, Hypercholesterolemia, editorial

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Elevated Serum Estradiol and Testosterone Concentrations Are Associated with a High Risk for Breast Cancer

Article Abstract:

High levels of estradiol (a natural form of estrogen) and testosterone seem to be associated with the development of breast cancer in older women, and measurement of estradiol and free testosterone may indicate a woman's risk for breast cancer. Two groups of women, one of 97 women with breast cancer and one group of 244 women chosen randomly had their sex-steroid hormone levels measured, other risk factors determined, and this data was compared against cases of breast cancer. Those with the highest hormonal concentrations had multiple times the risk of breast cancer to a dramatically significant degree.

Measurement, Risk factors, Breast cancer, Testosterone, Estradiol

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