for the well-proven alternatives of appropriate diet, exercise, and drugs." It has been argued that the health benefits from alcohol are at best debatable and may have been exaggerated by the alcohol industry, with investigators holding that alcohol should be regarded as a recreational drug with potentially serious adverse effects on health and should not be promoted for cardio-protection. Peripheral arterial disease A prospective study published in 1997 found "moderate alcohol consumption appears to decrease the risk of PAD in apparently healthy men." In a large population-based study, moderate alcohol consumption was inversely associated with peripheral arterial disease in women but not in men. But when confounding by smoking was considered, the benefit extended to men. The study concluded "an inverse association between alcohol consumption and peripheral arterial disease was found in nonsmoking men and women." Intermittent claudication A study found that moderate consumption of alcohol had a protective effect against intermittent claudication. The lowest risk was seen in men who drank 1 to 2 drinks per day and in women who drank half to 1 drink per day. Heart attack and stroke Drinking in moderation has been found to help those who have had a heart attack survive it. However, excessive alcohol consumption leads to an increased risk of heart failure. A review of the literature found that half a drink of alcohol offered the best level of protection. However, they noted that at present there have been no randomised trials to confirm the evidence which suggests a protective role of low doses of alcohol against heart attacks. There is an increased risk of hypertriglyceridemia, cardiomyopathy, hypertension, and stroke if three or more standard drinks of alcohol are taken per day. A systematic review reported that reducing alcohol intake lowers blood pressure in a dose-dependent manner in heavy drinkers. For people who drank two or fewer drinks per day, no difference was found. Cardiomyopathy Large amount of alcohol over the long term can lead to alcoholic cardiomyopathy. Alcoholic cardiomyopathy presents in a manner clinically identical to idiopathic dilated cardiomyopathy, involving hypertrophy of the musculature of the heart that can lead to congestive heart failure. Hematologic diseases Alcoholics may have anemia from several causes; they may also develop thrombocytopenia from direct toxic effect on megakaryocytes, or from hypersplenism. Atrial fibrillation Alcohol consumption increases the risk of atrial fibrillation, a type of abnormal heart rhythm. This remains true even at moderate