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With respect to cardiovascular disorders, epidemiologic studies support the hypothesis of increased risks among heavy alcohol drinkers and indicate a lower risk among lighter drinkers. Increased cardiovascular risks of heavy drinking include cardiomyopathy, systemic hypertension, supraventricular arrhythmias, hemorrhagic stroke and heart failure that is not associated with coronary artery disease (CAD). Light-to-moderate drinking is probably unrelated to increased risk of any cardiovascular condition and is related to lower risks of CAD, ischemic stroke and CAD-related heart failure. A protective alcohol–CAD hypothesis is supported by plausible biological mechanisms attributable to ethyl alcohol. Possible nonalcohol beneficial components in wine (especially red) could explain the extra protection of wine, but a healthier pattern of drinking or more favorable risk traits in wine drinkers may also be involved. Advice regarding the advisability of alcohol drinking for health needs to be individualized according to specific risks and benefits.