ABSTRACT
Light and moderate drinking has consistently been associated with lower risk of coronary heart disease [1-4]. Several studies have suggested that specific types of drink may have different effects on coronary heart disease (CHD) [5,6]. In recent years, much research has focused on the question of whether wines in particular have specific qualities not associated with other types of alcoholic beverage. Studies have suggested a possible role of antioxidants or bioflavanoids [7,8] and of antithrombotic and platelet activity in wine [9,10]. This has lead investigators to postulate that the protective effect of alcohol is only derived from wine drinking or that wine consumption is most beneficial [5,6]. However, a systematic review of ecological, case-control and prospective studies concluded that all alcoholic drinks were linked with lower risk of CHD but there was no consensus concerning the issue of wine drinking being most beneficial [11]. In many of the study populations reviewed, drinks are limited to one or two alcohol-types. Relatively few investigations have been able to compare the effects of different types of drink within the same study population and not surprisingly the findings have not been consistent [12-20]. It is speculated that the apparent differences in effects of alcoholic beverages may be due to differences in lifestyle or behavioural and drinking patterns associated with beverage type. In support of this argument, data from the British Regional Heart Study, a large prospective study of 7735 middle-aged men drawn from 24 towns, was used to examine the role of lifestyle factors in the differential effects of alcoholic beverages on CHD and mortality. In this chapter, we summarise our findings on the relationships between beer, spirit and wine drinking and risk of major CHD events and of all cause mortality, taking into account the differences in lifestyle and personal characteristics associated with beverage type [20]. We also attempt to evaluate the confounding role of lifestyle factors.
