The recent study of Zhou et al showed negative effects of alcohol consumption on the risk for coronary artery disease. Despite a large number of observational studies showing protective effects of moderate alcohol consumption on heart disease, we consider the findings of Zhou et al1 to be valid. Apparent cardio-protective effects of moderate alcohol consumption may well be an artifact of uncontrolled confounding, similar to the misleading observation from epidemiologic studies, now known to be an aberration of methodologic bias, that female hormone replacement therapy is protective against heart disease. Moderate drinking has been found to be associated with clusters of factors (confounders), all closely associated with socioeconomic status, that are protective against coronary heart diseases.
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