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Alcoholism And Heart Attacks

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Does Alcohol Affect Everyone The Same Way

Study: Alcohol abuse damages heart

Alcohol affects people in different ways. For the most part, men can consume more alcohol than women before being considered impaired. Also, a persons weight and size plays a role in how they handle alcohol. Much of our bodies are water. Water dilutes alcohol, so the more water there is, the more diluted the alcohol becomes. This means a person on a smaller frame will experience more of the effects of alcohol than a person with a larger frame. Another consideration is genetics. Scientists have learned that humans have enzymes that control how alcohol affects the body, but not all humans have the gene that creates the enzymes or can create enough to deal with large amounts of alcohol. Those who have the gene and the enzymes can better handle alcohol than those who do not.

Can Alcohol Interfere With Medications

If you take medications, especially antidepressants, antibiotics or pain medications, ask your doctor if it is safe for you to drink alcohol. Combining alcohol with some medications can keep the medications from working as they should and cause serious side effects. You should not drink alcohol if you are pregnant.

Alcohol Abuse Increases Risk Of Heart Attack Atrial Fibrillation And Heart Failure

Despite Myths, Reducing Alcohol Intake Could Reduce Cardiovascular Disease

Alcohol abuse may increase the risk for heart attack, atrial fibrillation and congestive heart failure, according to UC San Francisco researchers, who say efforts to reduce this condition could result in meaningful reductions of overall cardiovascular disease.

Their study, which evaluated the health data of more than 14.7 million Americans, appears in the Jan. 10, 2017, issue of the Journal of the American College of Cardiology .

While generally believed that alcohol is protective against heart attacks, these findings demonstrate that excessive alcohol consumption may actually substantially increase risk, said senior author Gregory Marcus, MD, MAS, a UCSF Health cardiologist and director of clinical research in the UCSF Division of Cardiology. And, while alcohol as a risk factor for AF and heart failure has long been known, we sought to leverage these millions of patient records to provide an assessment of the patient characteristics that might influence that risk.

Despite advances in prevention and treatments, cardiovascular disease continues to be the most prevalent threat to U.S. health, comprising more than a quarter of all deaths. More than 500,000 Americans suffered a first-time heart attack in 2015, and an estimated 6 million are affected by AF, the most common cardiac arrhythmia. There also are more than 870,000 new congestive heart failure diagnoses annually.

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How Much Alcohol Is Too Much

Whether or not moderate drinking is good for your heart is open to debate. However, for most people, it doesnt appear to be harmful to the heart but the key word is moderate.

Moderate drinking is defined as an average of one drink per day for women and one or two for men. A drink might be less than you think: 12 ounces of beer, 4 ounces of wine or 1.5 ounces of 80-proof spirits.

Some people should avoid even that much and not drink at all if they have certain heart rhythm abnormalities or have heart failure.

Derangements In Fatty Acid Metabolism And Transport

Alcohol And Heart Disease Symptoms

Derangements in fatty acid metabolism and transport and formation of fatty acid ethyl esters also have been implicated in ethanol-induced cell injury. FAEEs can be formed in the body during ethanol metabolism, when ethanol reacts with fatty acids or triglycerides. FAEEs can attach to mitochondria and disrupt mitochondrial function. Lange and Sobel were the first to identify an increase in FAEE content in postmortem myocardium samples obtained from those subjects who routinely had used large amounts of alcohol and who had a history of recent alcohol intoxication .

The idea that FAEEs are involved in ACM pathogenesis and are cytotoxic is supported by the fact that increased tissue levels of FAEE are considered the mechanism underlying cell death induced using a procedure to control and prevent recurrence of cardiac arrhythmias .

Other researchers have confirmed in animal models that long-term ethanol consumption can also affect long-chain fatty acid uptake, as well as increased expression of the genes encoding for proteins involved in the formation of triglycerides from free fatty acids and glycerol, or triglyceride esterification, and in LCFA transporters .4

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Abuse Associated With Increased Risks

Among 14,727,591 residents in the database, 268,084 were coded with an alcohol abuse diagnosis. The researchers analysis found that alcohol abuse was associated with an increased risk of heart attack, AF and congestive heart failure of at least a similar magnitude to well-established risk factors for each disease.

Specifically, those California residents with alcohol abuse had more than three times the risk of AF, much higher than the majority of well-established risk factors. For heart attack and congestive heart failure, the risk from alcohol abuse was similar to multiple well-established risk factors such as diabetes and high blood pressure.

Further, individuals without the conventional risk factors for cardiovascular disease exhibited a disproportionately enhanced risk for all three conditions.

Extrapolating data to the estimated prevalence of each disease, the complete eradication of alcohol abuse could result in more than 73,000 fewer cases of atrial fibrillation, 34,000 fewer heart attacks and 91,000 fewer congestive heart failure patients in the United States.

Other contributors to the JACC study were lead author Isaac Whitman, MD, Gregory Nah, MA, and Eric Vittinghoff, PhD, of UCSF Vratika Agarwal, MD, Staten Island University Hospital Jonathan Dukes, MD, Cardiology Associates Medical Group and former UCSF cardiology clinical fellow and Thomas Dewland, MD, Oregon Health & Science University and former UCSF resident and cardiology electrophysiology fellow.

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Such deaths are 2 1/2 times more common in men than in women, but rose for both in 2020, the study found. The rate continued to be highest for people ages 55 to 64, but rose dramatically for certain other groups, including jumping 42% among women ages 35 to 44.

The second report, published earlier this week in JAMA Network Open, looked at a wider range of deaths that could be linked to drinking, such as motor vehicle accidents, suicides, falls and cancers.

More than 140,000 of that broader category of alcohol-related deaths occur annually, based on data from 2015 to 2019, the researchers said. CDC researchers say about 82,000 of those deaths are from drinking too much over a long period of time and 58,000 from causes tied to acute intoxication.

The study found that as many as 1 in 8 deaths among U.S. adults ages 20 to 64 were alcohol-related deaths. New Mexico was the state with the highest percentage of alcohol-related deaths, 22%. Mississippi had the lowest, 9%.

Excessive drinking is associated with chronic dangers such as liver cancer, high blood pressure, stroke and heart disease. Drinking by pregnant women can lead to miscarriage, stillbirth or birth defects. And health officials say alcohol is a factor in as many as one-third of serious falls among the elderly.

Its also a risk to others through drunken driving or alcohol-fueled violence. Surveys suggest that more than half the alcohol sold in the U.S. is consumed during binge drinking episodes.

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What Are The Symptoms Of Alcoholic Cardiomyopathy

One of the most troubling aspects of alcoholic cardiomyopathy is that it can happen without warning. Most people dont experience any symptoms until it starts to cause heart failure. When you do start to experience symptoms, they may be consistent with the symptoms of typical heart problems. Alcohol and heart disease symptoms include:

  • Fatigue, easily tiring out
  • Shortness of breath, even with minor tasks
  • Persistent coughing
  • Difficulty concentrating
  • Muscle weakness

If you notice any of these symptoms, it could be a sign that something is wrong with your heart and that its not functioning properly. You should seek medical attention as soon as possible. However, if youve been drinking heavily for many years, you should speak to a doctor or cardiologist about your heart health, even if you dont feel any of these symptoms.

Alcohol And The Vasculature System

Dr. Scott Davis Talks Effects of Alcohol Abuse on Heart

A person who drinks alcohol heavily will likely have abnormal cholesterol levels. Cholesterol is a normal and healthy part of the blood, but they can malfunction. Cholesterol is large molecules that carry lipids to various parts of the body, and lipids are used to construct the membranes of cells.

When there are too many lipids , they scratch the inner membranes of the veins and arteries, which causes mechanical damage, and different cells are recruited in the blood to help repair the damage.

However, since blood is designed to clot when it repairs the damage, it can mistakenly build a clot on the inside of the vasculature system. If this clot continues to build, it can break off and travel to the veins that feed oxygen to the heart. If the clot gets lodged there, the oxygen supply feeding the blood cells is cut off, causing a heart attack.

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What Causes This Condition

Alcohol has toxic effects, but your body can limit the damage and break alcohol down into non-toxic forms if you dont drink too much too quickly. However, consistent heavy drinking strains those protective processes especially in your liver making them less effective. Ultimately, your body cant keep up with the damage to multiple organ systems, including your heart.

While alcoholic cardiomyopathy comes from long-term alcohol abuse, theres no universal limit or number that means youll develop it. However, researchers have pinpointed certain behaviors that make it more likely youll develop this condition.

  • Heavy drinking. Available research shows that drinking 80g of alcohol or more daily for at least five years can greatly increase your risk of developing this condition.
  • Frequent binge drinking. Theres evidence that repeated binge drinking may also be enough to increase your risk of this condition. The definition of binge drinking is consuming, on a single occasion , four or more drinks for women and five or more drinks for men.
  • Genetic mutations. Some people have a genetic mutation that makes their body process alcohol slower than others. For them, intoxication and damage to their bodies from alcohols toxic effects takes fewer drinks and lasts longer. Over time, that increased damage can lead to problems like alcoholic cardiomyopathy.

American Heart Association News Stories

American Heart Association News covers heart disease, stroke and related health issues. Not all views expressed in American Heart Association News stories reflect the official position of the American Heart Association. Statements, conclusions, accuracy and reliability of studies published in American Heart Association scientific journals or presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the American Heart Associations official guidance, policies or positions.

Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, for individuals, media outlets, and non-commercial education and awareness efforts to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered and proper attribution is made to American Heart Association News.

Other uses, including educational products or services sold for profit, must comply with the American Heart Associations Copyright Permission Guidelines. See full terms of use. These stories may not be used to promote or endorse a commercial product or service.

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How Is Alcoholic Cardiomyopathy Treated

The first step in treating alcoholic cardiomyopathy is to stop drinking. Continuing to use or misuse alcohol can cause your condition to worsen and frustrate any attempts to repair the damage to your heart. Addiction treatment is a multidisciplinary process thats used to treat the physical, psychological, and behavioral aspects of substance abuse. When you stop drinking, some of the long-term effects may begin to reverse. Your liver has a remarkable ability to repair and heal. Liver damage may begin to reverse immediately, repairing dramatically within a few weeks.

Your heart may be less efficient when it comes to repairing, but quitting alcohol misuse can help it to heal. However, there are other things your doctor may recommend to help your heart recover from alcoholic cardiomyopathy. Like other forms of heart disease, some lifestyle changes may allow your heart to recover from excessive alcohol use. Your doctor may recommend a low-salt diet and other heart-healthy dietary changes.

You may also be prescribed medications for specific conditions that can be dangerous for your heart. Diuretics can help remove excess water and salt from your heart thats caused by fluid retention. If you have hypertension, your doctor may prescribe beta-blockers or ACE inhibitors to lower your blood pressure. Alcoholic cardiomyopathy recovery time will depend on the extent of damage.

How Does This Condition Affect My Body

Alcoholic Cardiomyopathy FAQs, Life Expectancy, and Recovery

Alcoholic cardiomyopathy is a type of dilated cardiomyopathy, which is when your hearts shape changes because its muscles are stretching too much. As the muscles stretch more and more, they also weaken. The effect is much like how a rubber band or spring weakens when stretched too much.

The muscles that control the lower chambers of your heart, the left and right ventricle, are especially prone to this kind of stretching. These chambers are important as they do the majority of the work of your heart, with the right ventricle pumping blood to your lungs and the left ventricle pumping blood to your entire body. Weakening in the muscles around the ventricles means they cant pump as hard, which negatively affects your entire body.

Changes in your hearts shape can also disrupt that organs electrical system. An electrical current travels through your entire heart with every heartbeat, causing each part of the heart to squeeze in a specific sequence. Your hearts shape is part of how that timing works, and when parts of your heart stretch, it can disrupt that timing. If it takes too long even by tiny fractions of a second that delay can cause your heart to beat out of sync . Similarly, alcohol can have a toxic effect on your heart and cause scar tissue to form. That scar tissue can also cause potentially life-threatening arrhythmias .

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Can A Person With Heart Disease Drink Alcohol

A person with heart disease can drink alcohol, but it may increase their risk of complications.

According to the United Kingdomâs British Heart Foundation, an individual with a heart condition that causes arrhythmias may be more likely to experience one if they drink alcohol. Additionally, people with inherited heart conditions are at particular risk.

If a person has already experienced an arrhythmia, there is a higher chance of a recurrence.

Some observational studies suggest that moderate alcohol intake may have links to a lower risk of heart disease. A study from the American College of Cardiology suggests that small amounts of alcohol â no more than one drink for women and two for men per day â may calm stress signals in the brain, which may be the mechanism for lower risk.

Stopping drinking or reducing alcohol intake can lower a personâs blood pressure and reduce their risk of a heart attack.

However, the consensus among medical professionals is that the drawbacks of alcohol far outweigh any of its suggested benefits.

  • family history of heart disease

What Is A Heart Attack

A heart attack, also referred to as a myocardial infarction, occurs when blood flow to the heart is blocked. When an artery that feeds blood to the heart becomes blocked, it can slow and prevent proper blood flow. Also, part of the blockage can break free and lodge further down the path, preventing blood from getting to the heart, which causes damage to the muscle. Either of these scenarios can cause a heart attack, and a person who thinks they might be having one should call 911 immediately. Although they can be fatal, treatments for heart attacks have vastly improved over the last decade, but immediate treatment is key to recovery.

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Recovering From An Alcohol

Alcohol and heart attack recovery is the same as recovering from any other heart attack. Each person is different, but treatment following a heart attack may involve:

  • Reducing or stopping alcohol use
  • Medications to break up the clot in the heart
  • Catheterization, which is when a tube is surgically threaded into the arteries of the heart to help break up the clot
  • Lifestyle changes, including diet and exercise
  • Surgical procedures, if necessary
  • Diagnostic testing by a medical professional
  • Getting sufficient rest
  • Follow-up medical appointments

One of the most important ways to heal from an alcohol-related heart attack is to address the issue of alcohol use. A persons risk of other heart attacks and other health-related conditions goes up as they continue to drink alcohol. To address the underlying causes of alcoholism, a person can enroll in an alcohol rehab treatment program to overcome addiction with the help of medical professionals.

Ask A Cardiologist: Alcohol And Heart Health

Drink alcohol and save yourself a heart disease Cardiologist
Q: Ive heard that drinking a glass of wine a day is good for the heart. Is this true?

A: Drinking a small amount of alcohol is likely not harmful for your heart. But the idea that drinking alcohol might be good for your overall health isnt fully backed by science.

Over the years some studies have associated drinking small amounts of alcohol with lowered risk of heart disease. In those studies, people who drank moderate amounts of alcohol had about a 20% lower risk of dying from heart disease including heart attack, atrial fibrillation, heart failure and coronary artery disease when compared to those who didnt drink. This trend seems to hold for people who are living with heart disease and those who arent. And the benefits were seen whether drinking wine, beer or spirits. These findings can be reassuring for most folks but they are certainly not a recommendation to start drinking for health benefits.

Why you shouldnt start drinking for health
Benefits dont outweigh risks
  • two drinks a day most days, to a weekly maximum of 10 for women.*
  • three drinks a day most days, to a weekly maximum of 15 for men.A drink means
  • 341 mL / 12 oz of regular strength beer .
  • 142 mL / 5 oz wine .
  • 43 mL / 1 1/2 oz spirits .

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