Alcohol: lipid metabolism and cardioprotection.

The decision to consume alcohol is associated with risks and benefits that vary according to family history (genes) and environment. The risk for coronary heart disease (CHD) is reduced in populations that regularly consume moderate amounts of alcohol. The risk reduction is associated with increased plasma high-density lipoprotein (HDL) cholesterol. Predisposing factors may make some individuals more vulnerable to alcohol-related risks than others. For example, individuals with hypertriglyceridemia and a personal or family history of pancreatitis might consider the benefits of alcohol consumption not worth the health risks. The risks might be more acceptable to someone with a family history of CHD, normal plasma triglyceride levels, low HDL cholesterol, and no personal or family history of addictive behavior or pancreatitis. An understanding of the metabolic effects of alcohol and a careful study of personal and family histories should permit physicians and their patients to make informed decisions about the risks and benefits of alcohol consumption.