Alcohol: friend or foe?

Popular belief has it that alcohol, particularly red wine, protects against atherosclerosis and associated cardio- and cerebrovascular conditions. That presumption motivates this paper, which describes the mechanisms underlying the J-shaped risk curve for alcohol use, with benefits for vascular disease risk at low consumption levels and harmful effects-both directly on the user and indirectly on the bystander-at higher levels. The importance of further exploring alcohol use in patients with cardiovascular risk factors and of intervening to modify non-social use of alcohol to prevent serious adverse health consequences is also addressed.