Poll: Should doctors tell patients about the possible health benefits of alcohol?
Please participate in our poll:
Background:
Over 60 studies have shown that moderate alcohol ingestion (the equivalent of 1 or 2 drinks per day) increases HDL cholesterol levels (the "good" cholesterol) by approximately 12 percent. Other studies suggest that certain populations that consume wine regularly have a low incidence of cardiac disease despite high-fat diets. Such data has led to widespread interest in the possibility that alcohol can protect from cardiovascular disease.
However, a special plea from an American Heart Association advisory panel, published in this month's Circulation, urges doctors to refrain from encouraging alcohol ingestion as a means of reducing cardiovascular risk.
Arguments against telling patients about the potential benefits of alcohol are:
- alcohol is an addictive substance, and for many people
it is very difficult to "stop" with one or two drinks a day
- more than moderate ingestion of alcohol can cause severe
health problems
- in some individuals, even one or two drinks a day can cause
health problems
- while the evidence in favor of alcohol is suggestive, it
has not been proven in scientific studies
- proven methods of reducing risk - exercise, diet, weight
loss, stopping tobacco use, and medications - should be used instead
However, the fact remains that a) there is much evidence that alcohol in small amounts can reduce cardiac risk, and b) some individuals continue to have low HDL levels despite other risk factor modifications. Further, some insist that purposefully withholding potentially useful information from patients, in the fear that they will abuse that information, is unnecessarily paternalistic. According to this argument, as long as doctors include the 5 anti-alcohol arguments used by the AHA panel, they ought to inform patients of the state of our knowledge on the potential health benefits of alcohol.
Who is right?
The Poll:
What do you think? Enter the Heart Disease Forum:
