A number of studies have dissected the J-shaped curve into specific diseases. It is clear that a stepwise decline in CHD death occurs with increasing drinks per day. Because CHD accounts for one third or more of total deaths, those with no alcohol consumption have higher total mortality than those drinking one to two drinks per day. On the other hand, mortality due to a large number of other diseases increases with an increasing number of drinks consumed per day. Heavy consumption of alcohol also appears to affect heart muscle and possibly arterial tissues directly.
Alcoholic cardiomyopathy is a common diagnosis in long-term alcoholics.
While the relative and absolute risks of these diseases are negligible at one or two drinks per day, the mortality rates rise sharply. The J-shaped distribution for total mortality is then the sum of the protective effect on CHD mortality and the detrimental effect of high levels of consumption on these other causes of death. The data are similar in men and women in a number of different geographic and ethnic groups. 15 Studies of coronary narrowings defined by cardiac catheterization or autopsy show a reduction in atherosclerosis in persons who consume moderate amounts of alcohol. In general, the inverse association is independent of potential confounders, such as diet and cigarette smoking.