Lipoprotein disorders are a major risk factor for atherosclerotic neuro-cardiovascular disease
(ACVD) and are heavily influenced by lifestyle, including alcohol drinking. Moderate drinkers
have a lower ACVD risk than abstainers due to their higher levels of high-density lipoprotein
(HDL) cholesterol, an important protective factor against ACVD. On the contrary, heavy drinking
increases ACVD risk. According to an extensive literature body, ethanol intoxication modifies
lipid serum profile and induces endothelial dysfunction. Single nucleotide polymorphisms may influence
the relationship between alcohol drinking, HDL cholesterol level, and atherosclerotic risk.
The risk of ACVD in heavy drinkers seems enhanced in patients with apolipoprotein E4 allele, interleukin-
6-174 polymorphism, and cholesteryl ester transfer protein TaqIB polymorphism.
Apolipoprotein E4 is a known risk factor for ACVD, while apolipoprotein E2 has mixed effects.
Therefore, even if a “protective role” may be attributed to moderate drinking, this effect cannot be
extended to everyone.