Thirty years ago, scientists studying the incidence of heart disease in different countries around the world found themselves baffled by one particular finding: the French, despite having a diet rich in the kind of fats that cause atherosclerosis, had much lower levels of heart disease than the English. After years of research into what became known as the “French paradox,” some scientists think they’ve solved the puzzle: the French drink a lot of wine.

Several large-scale studies have demonstrated that people who regularly have one to three alcoholic drinks a day have a 10 to 40 percent lower risk of developing heart disease than people who don’t drink at all. Moderate alcohol consumption also may lower the risk for heart failure and stroke (although drinking large amounts of alcohol may increase that risk).

How Alcohol Protects the Heart

Scientists are not yet certain about how alcohol consumption protects the heart, but there are several possible answers. There are antioxidants in wine, and antioxidants are known to help keep LDL (bad) cholesterol from accumulating into plaques and keep platelets in the blood from forming clots.

And a recent review of forty-two studies suggests that alcohol may protect the heart by raising HDL (good) cholesterol levels and lowering levels of fibrinogen, another substance that promotes clotting. There is also evidence that alcohol may fight inflammation in the blood vessels.

Unfortunately, none of the research conducted to date addresses the question of whether drinking alcohol holds benefits for people who already have been diagnosed with heart disease. All we can say with any certainty is that if you have heart disease and have been drinking moderately for some time, it probably isn’t hurting you and may well be helping.

What Kind? How Often? How Much?

Early research suggested that wine and red wine in particular was more protective against heart disease and cancer than other alcoholic beverages. But a recent study of more than 38,000 men found that when it comes to lowering the risk of heart attack, the type of alcohol (beer, red wine, white wine, or liquor) does not matter.

Indeed, this same study concluded that how often you drink alcohol may matter more than what you drink or how much. It turns out that men who drank moderately three to seven days a week were far less likely to develop heart disease than those who drank only one or two days a week.

These research results are not a green light for heavy drinking. The American Heart Association recommends that women consume no more than one alcoholic drink per day and men no more than two. The experts agree that more than three drinks per day is hazardous for anyone and for many people, problems can develop at even lower levels.

Alcohol can be addictive and can lead to physical abuse, accidents, high blood pressure, liver disease, and cancers of the mouth, throat, esophagus, and breast. One recent study showed that as many as half of all moderate drinkers have binge-drinking episodes, which are highly associated with alcohol-impaired driving.

By the way, if you’re a non-drinker now, you probably shouldn’t start. One study of non-drinkers who took up moderate drinking at midlife concluded that the reduction of heart attack risk was minimal. Finally, some people should avoid drinking altogether.

The American Heart Association has concluded that if you have any of the following conditions, the risks of drinking alcohol far outweigh the benefits:

• A personal or strong family history of alcoholism.
• Uncontrolled high blood pressure.
• High blood triglyceride levels.
• Heart failure.
• Pregnancy.
• Porphyria (a genetic disorder).
• Pancreatitis (disease of the pancreas).
• Use of medications that interact with alcohol.