SAN FRANCISCO — Moderate consumption of alcohol can be part of a healthy lifestyle to prevent cardiac disease, but not if you drink too fast, Dr. Mary O. Gray said at a meeting sponsored by the California chapter of the American College of Cardiology.
The cardioprotective benefits of alcohol appear to be limited to one drink per day for women or two drinks per day for men (with a “drink” consisting of one glass of wine, one shot of liquor, or one bottle or can of beer). Beyond that, alcohol is cardiotoxic, said Dr. Gray of San Francisco General Hospital.
Binge drinking—defined as consuming three or more drinks in 1 or 2 hours—doubled the risk of death from any cause in a recent study of patients treated for acute MI (Circulation 2005;112:3839–45). Investigators interviewed 2,000 patients a median of 4 days after a confirmed MI and found that regular consumption of alcohol reduced their risk of death, but binge drinking blocked or attenuated this benefit.
The negative effects of binge drinking applied regardless of whether a person was a light or heavy drinker overall. The study also asked about other factors that might affect cardiovascular risk, such as vigorous activity or vigorous sexual activity, but found no correlation with mortality, she said at the meeting, also sponsored by the University of California, San Francisco.
Heavy drinking for a long time can cause alcoholic cardiomyopathy, a diagnosis made clinically through history and elimination of other etiologies. Heavy drinkers with hypertension or heart failure should be advised to stop drinking to preserve their hearts, as well as to protect other aspects of their physical and personal/social well-being.
Data on very heavy drinkers suggest that those who develop heart failure may recover cardiovascular function if they stop drinking. Recovery is more likely if the patient is relatively young and has no other risk factors for cardiovascular disease.
Heavy drinkers often are malnourished, so treatment should include attention to a healthy diet including thiamine supplementation, Dr. Gray advised. Treat cardiac arrhythmias or systemic hypertension promptly in heavy drinkers, she added.
Most heavy drinkers also are heavy cigarette smokers. Dr. Gray and associates plan to study the interplay between cigarette smoke and alcohol consumption to try to tease out their causal effects in alcoholic cardiomyopathy.
Binge drinking doubled the risk of death in a study of patients being treated for acute MI. ©Boris Kaulin/FOTOLIA