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What is the Relationship Between Alcohol and Heart Disease?

From ​Dr. Richard Chazal, senior cardiologist and the Medical Director of Lee Health Heart and Vascular Institute, Past President of the American College of Cardiology and current Treasurer of the World Heart Federation, based in Geneva, Switzerland

Studies have shown that there is a direct link between alcohol and health issues, such as high blood pressure, which can eventually lead to heart disease. While it may take time for a drinker to potentially develop serious heart conditions, drinking in moderation (or abstinence for some) is healthier. It not only lessens your chances of heart disease, but it also decreases your risks of developing other serious medical conditions like cancer.

What is Considered Excessing Drinking?

According to the American Heart Association, moderate drinking is an average of one drink per day for women and one to two for men. A drink is defined as 12 ounces of beer, five ounces of wine or 1.5 ounces of 80-proof spirits.

For men, consuming more than 14 drinks per week is considered excessive. For women, it’s consuming more than seven drinks each week. Heavy drinking can not only lead to high blood pressure, but also heart failure, stroke or cardiomyopathy, a disorder that affects the heart muscle. These general rules are helpful guidance, but some people can develop medical issues with only minimal amounts of alcohol. A recent report generated by the World Heart Federation (and based on published studies) points out that even minimal amounts of alcohol can be deleterious to good health.

How Can Alcohol Affect your Heart?

Drinking excessively won’t automatically lead to heart disease, but alcohol can affect your heart in a variety of other ways.

Irregular Heartbeat

Someone may experience an irregular heartbeat when they consume more alcohol than usual. For example, this could happen during the holidays when families gather more frequently and alcohol becomes prevalent during celebrations. Enjoying celebratory spirits in moderation is normally fine for most people, but it’s important to be aware of ‘holiday heart syndrome’ if you overdo it, especially if you don’t typically drink. Overeating and overindulging in alcohol may lead to an irregular heartbeat, called atrial fibrillation, which can increase your risk of stroke, heart attack and heart failure.

Elevated Blood Pressure

Many people do not realize that alcohol can affect blood pressure. Alcohol consumption is among the most common reversible causes of high blood pressure. This can be especially true when someone engages in binge drinking (four or more drinks in two hours for women and five or more drinks within two hours for men).

If you have a history of high blood pressure, it’s wise to consider avoiding alcohol completely or only having an occasional drink.

Alcohol-Related Cardiomyopathy

In addition to the immediate effects of alcohol on your body, drinking can also cause long-term conditions like alcohol-related cardiomyopathy. This is when the heart-pumping function gets weaker and the heart becomes larger due to changes from alcohol use. If the condition is caught early enough and the damage is not severe, it can be treated (most importantly with cessation of alcohol). While this type of condition is usually associated with chronic heavy consumption, some people’s hearts seem more susceptible than others, leading to cardiomyopathy with only ‘social’ drinking.

Other Factors Such as Age and Medical History

Age plays a significant role in the ability to process alcohol and how it affects our bodies. As we get older, our ability to clear alcohol decreases and our sensitivity to it increases. Additionally, we’re more prone to having more medical problems and health conditions as we age, and we are more likely to be on medication. This is important, as medications can sometimes interfere with the metabolism of alcohol and alcohol may interfere with the metabolism of medications. It’s crucial that your physician is aware of an accurate estimate of your alcohol consumption to help account for drug interactions.

In addition to using alcohol responsibly, it’s important to make healthy lifestyle choices, such as eating a balanced diet, getting regular exercise, getting enough sleep, and not smoking. If you have a family history of heart disease, make sure you tell your physician and get regular check-ups.

If you're feeling pain in your chest, dizziness or shortness of breath, consult with your physician as soon as possible.