Alcohol and the heart

Alcohol is a drug that affects all parts of the body. It has important effects on the heart and influences your risk of developing heart disease.

Long-term excessive drinking increases your risk of developing problems with your heart. Drinking within the daily unit guidelines is unlikely to cause damage and may help protect the heart. The guidelines for safe drinking recommend that for healthy men and women, drinking no more than two standard drinks on any day reduces your risk of harm from alcohol-related disease or injury over a lifetime. Drinking no more than four standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion.

Women who drink more than three units of alcohol a day and men who drink more than four are more likely to suffer from diseases affecting the heart or blood vessels.Men nearly double their chances of developing coronary heart disease by regularly drinking more than eight units of alcohol a day. Women have a 1.3 times greater risk of developing coronary heart disease when they regularly drink more than six units a day.

Long-term, heavy drinking can lead to heart disease. Drinking more than the daily unit guidelines regularly and over a long period of time can increase your risk of developing heart disease. This is because, drinking at this level can:

Increase the risk of high blood pressure. Drinking excessive amounts of alcohol causes raised blood pressure, which is one of the most important risk factors for having a heart attack or a stroke. Alcohol is thought to do this through its effects on the kidneys and the blood vessels. Increases in your blood pressure can also be caused by weight gain from excessive drinking.

Weaken the heart muscle. This means the heart can’t pump blood as efficiently. This condition is known as  known as cardiomyopathy and can cause premature death, usually through cardiomyopathy and heart failure.

Binge drinking can make your heart beat irregularly. The name Holiday Heart Syndrome is misleading. People who have it certainly won’t be having a leisurely time. In fact they might feel like they are having a heart attack – characterized by severe pain in the center of the chest. It gets its name because cases of the condition tend to increase around holiday times or after weekends, when people tend to drink more. Holiday Heart Syndrome tends to come on after episodes of heavy drinking – usually at least 15 units (about seven and a half pints of 4% beer or one and a half bottles of 13% wine).  If this happens, your heart starts to beat irregularly making you feel breathless. Your blood pressure changes, increasing your risk of a heart attack and sudden death.

Research suggests that small amounts of alcohol can have a protective effect on your heart.  This benefit appears to be restricted to over 45-year-olds drinking well within the recommended guidelines. Scientists aren’t sure how alcohol has the protective effect but think there are two main mechanisms. Alcohol appears to increase the level of ‘good’ cholesterol (HDL) in the blood. This reduces the amount of fatty deposit (atheroma), which narrows our arteries and makes them more likely to clog. Alcohol can help prevent the formation of blood clots, which can close off the arteries, causing a heart attack. It can stop platelets from clumping together to form clots and a small amount of alcohol with a meal can reduce the sudden rise of a protein (fibrinogen) produced by the liver. This increases the likelihood of harmful blood clots forming, called thrombosis.

We don’t know yet if alcohol can ever really be good for the heart. More research is needed to show whether drinking red wine is “good for the heart”. Laboratory studies in animals suggest that antioxidants help to prevent thrombosis. Red wine has a high concentration of antioxidant substances called flavonoids. White alcoholic drinks, like vodka and cider, contain the least concentration of flavonoids. But other alcohols, such as beer, have the same antioxidant effect as wine.

Much of the interest in red wine comes from the observation that the French (who have a long tradition of drinking red wine) often have healthy hearts and arteries despite typically having high-fat foods in their diet. But studies show that people who drink wine over other types of alcohol tend to live healthier lives, smoking less, drinking less and having a healthier diet. So these other factors, rather than the red wine, may in fact be responsible for their good health.

Drinking alcohol to protect oneself from heart disease is not recommended, as health experts, both in Australia and abroad, agree that the potential benefit is not worth the risk. For example, alcohol’s anti-clotting ability, potentially protective against heart attack, may increase the risk of hemorrhagic stroke (when a blood vessel bursts inside the brain), or bleeding within the brain.  Beyond the daily unit guidelines, alcohol’s potential benefits on the heart are outweighed by its increased risks of developing other illnesses, such as liver disease or cancer. There are safer ways to reduce your risk of developing heart disease. See the article in this section titled “prevention of heart disease”.

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