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OPINION STATEMENT: Moderate alcohol intake is beneficial to the heart and cardiovascular system. A J- or U-shaped response has been shown in the majority of studies examining alcohol's effect on cardiovascular mortality and downstream cardio-metabolic effects, with heavy alcohol intake associated with worse outcomes. These effects apply to individuals with and without underlying coronary artery disease. However, care must be taken in defining "moderate" intake between the sexes. Males appear to have a wider therapeutic window and can afford 2 to 3 drinks per day whereas women should limit intake to 1 to 2 drinks per day (a "drink" being classified as 10 to 14 grams of alcohol). More than half of alcohol's cardioprotective effects can be attributed to its effect on lipoproteins, specifically an increase in high-density lipoprotein. Interestingly, the risk of cardiovascular mortality in former heavy drinkers has been shown to ultimately approach the risk seen in lifelong abstainers.
RESUMO
With an occurrence of approximately 1 in 500 individuals worldwide, the heterozygous form of familial hypercholesterolemia is not uncommon. With statins being contraindicated in pregnancy (Category X), the management of pregnant women who carry this diagnosis has not been clearly defined. This case series describes five pregnant women seen at the Emory Center for Heart Disease Prevention between 2004 and 2010 who carried this diagnosis, their treatment, and subsequent outcomes. The article concludes with treatment options for clinicians in dealing with such individuals.