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. 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 2,000 patients treated for acute MI (Circulation 2005;112:3839–45). Regular consumption of alcohol reduced 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, she said at the meeting, also sponsored by the University of California, San Francisco.
Heavy drinking for a long time can cause alcoholic cardiomyopathy. Heavy drinkers with hypertension or heart failure should be advised to stop drinking to preserve their hearts. 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 has no other cardiovascular risk factors for 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 smoking and alcohol consumption.