Alcohol consumption had no beneficial effect on serum lipids in a substantial proportion of patients with primary hyperlipidemia

The cardioprotective effect of moderate alcohol consumption, which is media ted largely by an elevation of high-density lipoprotein (HDL) levels, may b e absent in patients with primary disorders of lipid metabolism. In 881 unt reated, unrelated patients with primary hyperlipidemia, we estimated the ef fect of alcohol on fasting serum HDL cholesterol concentration adjusted for age, gender, diet, and smoking with a multiple linear regression model. Th e number of abstainers, moderate users (1-30 g daily), and heavy alcohol co nsumers (greater than or equal to 30 g daily) was not different between thr ee types of hyperlipidemia. Among hypercholesterolemic (n = 514) and combin ed hyperlipidemic (n = 227) patients, consumers of alcohol had higher HDL l evels compared to abstainers (P-for trend = 0.0001 and 0.0002, respectively ). Heavy drinkers with combined hyperlipidemia had higher triglyceride leve ls compared to moderate drinkers and abstainers (P-for (trend) = 0.008). Al cohol consumption had no effect on the lipid profiles in 140 patients with hypertriglyceridemia. In conclusion, combined hyperlipidemic and hypertrigl yceridemic patients may profit from an encouragement to stop consuming alco hol. On the other hand, moderate use of alcohol may delay the development o f coronary artery disease in hypercholesterolemic patients by an elevation of HDL levels. (C) 2000 Elsevier Science Inc. All rights reserved.