For ischaemic heart disease and ischaemic stroke the relationship is more complex. Chronic heavy alcohol use has been uniformly associated with adverse cardiovascular outcomes [7;23;24]. For on average light to moderate drinking there is a protective effect on ischaemic diseases, which disappears when this drinking style contains irregular heavy drinking occasions [25;26]. For instance, Roerecke and Rehm found in a meta-analyses of studies, that consumption of 60g pure alcohol on one occasion among otherwise light to moderate drinkers was associated with no cardioprotective effect at all [25].
