A recent study published in the British Medical Journal (BMJ) shows that moderate alcohol consumption may reduce cardiovascular risk, but the relationship is very subtle. What are the implications of this study? Researchers combined UK primary care, hospital and mortality records to verify the association between alcohol consumption and 12 cardiovascular diseases in nearly 2 million people. These nearly 2 million people, both men and women, were free of cardiovascular disease at baseline. Follow-up was approximately 6 years, during which time there were approximately 115,000 new cardiovascular events. The results of the study showed that compared to moderate drinkers: 1. non-drinkers had a higher risk of unprecedented cardiac death, unstable angina, myocardial infarction, abdominal aortic aneurysm, heart failure, peripheral arterial disease and ischemic stroke; 2. heavy drinkers had a higher risk of cardiac arrest/sudden death, cerebral hemorrhage, peripheral arterial disease, ischemic stroke, heart failure, death without preceding coronary artery disease and transient ischemic attack 3. occasional drinkers had a higher risk of heart failure, myocardial infarction, death without coronary heart disease and peripheral artery disease; 4. those who had stopped drinking had some increased risk, but the authors said the findings were consistent with the hypothesis of “abstinence from alcohol because of illness” – that is, many people stop drinking when they are ill. The authors say that the findings are consistent with the hypothesis that people stop drinking when they are sick. In other words, although the study found a correlation between abstinence and disease, it is possible that the disease came first before abstinence; in a commentary accompanying the BMJ, two authors from Harvard Medical School and Johns Hopkins School of Public Health said the study used “big data to put the relationship between moderate drinking and risk reduction under the microscope “. They argue that the study does not present new insights into the relationship between moderate drinking and cardiovascular risk compared with past epidemiological studies, but sets the stage for larger, more complex big data studies in public health and clinical medicine in the future. What do we think about moderate drinking? Although this study provides relatively strong evidence for the cardiovascular protective effects of moderate drinking, the authors note that this does not mean that drinking is necessary in order to live a long life. Because it’s hard to know where to draw the line on moderate drinking, it’s possible that the protective effect could be easily offset by drinking too much; in addition, there are better ways to protect the heart: exercise and a healthy diet. Current evidence proves that moderate drinking can reduce the risk of coronary heart disease, but even moderate drinking may increase the risk of other diseases or adverse events, so overall it cannot be said that moderate drinking is healthier. Even Arthur Klatsky, one of the first scholars to suggest that moderate alcohol consumption reduces cardiovascular risk, advocates that the decision to advise a patient to drink in moderation should be made on a patient-by-patient basis. A 2014 study published in the BMJ showed that people who carry the “no alcohol” gene drink less alcohol and have a lower risk of cardiovascular disease. For these people, even if they were only light to moderate drinkers, reducing alcohol consumption would be beneficial for cardiovascular health. As medical research progresses, it may be possible to give more precise advice on the relationship between alcohol consumption and health in the future.