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Alcohol and Cardiovascular Disease

Alcohol consumption increases an individual's risk of cardiovascular disease.

How alcohol can damage the cardiovascular system

The heart and blood vessels form part of the cardiovascular system.1Blood is pumped around the body by the heart, via these blood vessels through arteries, capillaries and veins.2 The blood delivers nutrients and other materials to all parts of the body, including alcohol, which is absorbed directly into the blood stream mainly via the stomach and small intestine.

The cardiovascular system is affected by alcohol. At the time of drinking, alcohol can cause a temporary increase in heart rate and blood pressure. In the long-term, drinking above the guidelines can lead to on-going increased heart rate, high blood pressure, weakened heart muscle and irregular heartbeat. All of which can increase the risk of alcohol-caused heart attack and stroke.

Increased heart rate

Heart rate is the number of times the heartbeats per minute. Alcohol can cause variability in the way the heart beats – the time between heart beats. Studies have found that regular heavy drinking can cause episodes of tachycardia (increased heart rate due to problems in the electrical signals that produce a heartbeat). 6,7Complications due to regular episodes of tachycardia, do vary depending on their frequency, length and severity, but it can cause blood clots that can lead to a heart attack or stroke.8

Increased blood pressure

Blood pressure is a measure of the force blood places against blood vessel walls. High blood pressure is when the blood is pumping with more force than normal through the arteries.10Drinking alcohol on a single occasion can see a temporary increase in blood pressure, and regularly drinking alcohol above the national guidelines can cause alcohol-caused hypertension (high blood pressure). It is likely there are multiple mechanisms which cause alcohol to raise blood pressure,11 and studies have shown that a reduction in alcohol intake can lower blood pressure. 12High blood pressure can cause hardening and thickening of the arteries, and is a risk factor for heart attack and stroke.13,14The Australian Heart Foundation recommends having no more than two standard drinks on any day, as studies have found the consumption of more than two standard drinks a day can see an immediate increase in blood pressure, and increases the risk of developing hypertension.15

Weakened heart muscle

The heart is critical in getting oxygen and nutrients around the body and achieves this by generating the pressure for blood to circulate around the body, ensuring blood only flows in one direction. The frequency and force of the hearts contractions adjust depending on the needs of the body.17The anatomy of the heart is complex, but the heart’s ability to contract is due to the muscle layer within the heart wall. 18Heart muscle is called myocardium, and damaged heart muscle is called cardiomyopathy. Heavy alcohol consumption can lead to cardiomyopathy.19

Dilated cardiomyopathy results in weakened heart muscle that causes the four heart chambers to enlarge, resulting in weaker contractions (this makes it harder for the blood to circulate around the body).19,20 Cardiomyopathy can eventually lead to congestive heart failure, which is when the heart doesn’t pump enough for the needs of the body. 21,22

Irregular heart beat

A change in heart rhythm is called an arrhythmia. Arrhythmias can occur because of changes to the heart's electrical system, which can be caused by blocked signals, abnormal pathways, irritable heart cells, medicines and stimulants. Some of the common arrhythmias include the heart beating too slow (bradycardia), or too fast (tachycardia).23Arrhythmias can cause cardiac arrest and stroke.

The occurrence of acute cardiac rhythm disturbances (atrial fibrillation is the most common) have been found to be induced by alcohol. Sometimes referred to as ‘holiday heart’ these disturbances were found to be more frequent after weekends or holidays like Christmas or New Years which are known to have higher alcohol consumption.28>

Atrial fibrillation

Atrial fibrillation is one type of arrhythmia, and causes the upper chambers of the heart (the atriums) to quiver rather than beat normally. 24Alcohol causes atrial fibrillation through multiple mechanisms and can be seen both acutely (after one off drinking occasion) and from the cumulative effects of alcohol on the heart muscle.26,27This means blood does not circulate as efficiently as it should. This can result in blood, which hasn’t left the atrium, pool and clot. If the blood that has clotted within the atrium breaks off and is within the blood stream it can lodge in an artery within the brain causing an ischemic stroke.25

 

What cardiovascular diseases can alcohol cause?

Heart attack

Your heart muscle needs oxygen so it can keep pumping. A heart attack is when an artery supplying oxygen to the heart muscle is reduced or cut off completely, preventing the heart muscle receiving oxygen. The blood flow to the heart can be blocked due to a gradual build up of plaque, fat and cholesterol that cause a narrowing of the coronary arteries.
Alcohol consumption can raise the levels of fat in the blood. People with high triglycerides often have high levels of bad cholesterol and low levels of good cholesterol. High levels of bad cholesterol can clog arteries and if a piece of plaque breaks off, a clot forms and a heart attack can result.

Stroke

Alcohol consumption can increase the risk of two types of strokes occurring. Both result in a disrupted blood flow to brain tissue, and can result in a loss of motor (movement) and sensory (touch, temperature sensations) functions. A stroke can also damage other systems in the body including the skeletal, muscular, respiratory, digestive and urinary systems. 29

Ischemic stroke

This is when an artery supplying blood to the brain tissue is blocked. This blockage can result from a clot that has formed in the artery or from a foreign body (such as a fat globule) that has broken off that becomes lodged in the artery, blocking it.30

Alcohol increases the risk of ischemic stroke because it can:

  • Cause a clot, formed due to irregular heartbeat and weakened heart muscle, lodging in a blood vessel in the brain.
  • Cause high blood pressure which can result in a foreign body such as plaque to break off, enter the blood stream and lodge in a blood vessel in the brain.
  • Raise the levels of fat (bad cholesterol) in the blood and if a clot forms in a clogged artery a stroke can result.

Haemorrhagic stroke

This results from an artery supplying brain tissue, tearing and bleeding.31

Alcohol increases the risk of haemorrhagic stroke because it can cause high blood pressure. High blood pressure can create weak points on artery walls, including those in the brain, increasing the chance of them bleeding due to the force of high pressure.

Did you know that red wine is not good for you.

Australia’s Heart Foundation advises against the consumption of red wine, and other types of alcoholic beverages, to prevent or treat cardiovascular disease.32The Heart Foundation supports the National Health and Medical Research Council (NHMRC) recommendation for healthy Australians who already drink alcohol to have no more than two standard alcoholic drinks per day for men and women.33

The World Health Organisation strengthens this, by recommending eating a healthier diet and being physically active would be more effective in reducing the death from ischemic heart disease than by drinking a low dose of alcohol. 34

The facts and figures.

In 2014, alcohol-related stroke hospitalisation in Western Australia cost 1.2 million.35

It is estimated that 1 person per month died from alcohol-related stroke (2013 data) in Western Australia.36

In 2014 the estimated number of alcohol-related stroke hospitalisations was 59.37

 
References

1 Vanputte, C., Seeley, R., Regan, J., Russo.,A (2011). Antamony & Physiology., p. 646

2 Vanputte, C., Seeley, R., Regan, J., Russo.,A (2011). Antamony & Physiology., p. 646

3 National Health and Medical Research Council. (2001). Australian Alcohol Guidelines. Health risks and benefits.

4 Vanputte, C., Seeley, R., Regan, J., Russo.,A (2011). Antamony & Physiology., p. 701

5 Buckman, J. F., Eddie, D., Vaschillo, E. G., Vaschillo, B., Garcia, A., & Bates, M. E. (2015). Immediate and complex cardiovascular adaptation to an Acute alcohol dose. Alcoholism: Clinical and Experimental Research, 39(12), 2334-2344. doi:10.1111/acer.12912

6 Shi, P., Chen, Y., Guo, M., & Yu, H. (2014). acute effects of alcohol on heart rate variability: Time-related changes and gender difference. Biomedical Engineering Applications, Basis and Communications, 26(3), np-np. doi:10.4015/S1016237214500483

7 Buckman, J. F., Eddie, D., Vaschillo, E. G., Vaschillo, B., Garcia, A., & Bates, M. E. (2015). Immediate and complex cardiovascular adaptation to an Acute alcohol dose. Alcoholism: Clinical and Experimental Research, 39(12), 2334-2344. doi:10.1111/acer.12912

8 http://www.mayoclinic.org/diseases-conditions/tachycardia/basics/complications/con-20043012

9 Vanputte, C., Seeley, R., Regan, J., Russo.,A (2011). Antamony & Physiology., p. 749

10 https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/blood-pressure-high-hypertension

11Kazim Husain Rais A Ansari Leon Ferder. (2014). Alcohol-induced hypertension: Mechanism and prevention. 6(5), 245-252

12 N Kazim Husain Rais A Ansari Leon Ferder. (2014). Alcohol-induced hypertension: Mechanism and prevention. 6(5), 245-252

13 http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/complications/con-20019580

14 Heart Foundation (2016) Guidelines for the diagnosis and management of hypertension in adults. https://heartfoundation.org.au/images/uploads/publications/PRO-167_Hypertension-guideline-2016_WEB.pdf

15 Heart Foundation (2016) Guidelines for the diagnosis and management of hypertension in adults. P.30

16 Vanputte, C., Seeley, R., Regan, J., Russo.,A (2011). Antamony & Physiology., p. 675

17 Vanputte, C., Seeley, R., Regan, J., Russo.,A (2011). Antamony & Physiology., p. 675

18 Vanputte, C., Seeley, R., Regan, J., Russo.,A (2011). Antamony & Physiology., p. 679

19 B Vanputte, C., Seeley, R., Regan, J., Russo.,A (2011). Antamony & Physiology., p. 710

20 Zakhari, S. (1997). Alcohol and the Cardiovascular System. Alcohol health & research world, p. 22

21 https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/congestive-heart-failure-chf

22 Guo, R., & Ren, R. (2010). Alcohol and Acetaldehyde in Public Health: From Marvel to Menace. International Journal of Public Health, 7, 1285-1301. doi:10.3390/ijerph7041285 p.1287

23 National Heart Foundation. Arrithymias. Retrieved from - http://www.heartfoundation.org.au/SiteCollectionDocuments/Arrhythmias.pdf

24 https://www.heartfoundation.org.au/your-heart/heart-conditions/atrial-fibrillation-arrhythmia

25 http://www.heart.org/HEARTORG/Conditions/Arrhythmia/WhyArrhythmiaMatters/Why-Arrhythmia-Matters_UCM_002023_Article.jsp#.WBBY91V95hE

26 Podrid, P.J., & Kowney, P.R. (?).Cardiac Arrhythmia: Mechanisms, Diagnosis, and Management, p. 462

27 https://heartfoundation.org.au/images/uploads/main/For_professionals/CON-175_Atrial_Fibrillation_WEB.PDF

28 Tonelo, D., Providencia, R., & Goncalves, L., (2013). Holiday Heart Syndrome Revisted after 34 years, 101(2)., 183-18/9

29 Vanputte, C., Seeley, R., Regan, J., Russo.,A (2011). Antamony & Physiology., p. 503

30 Vanputte, C., Seeley, R., Regan, J., Russo.,A (2011). Antamony & Physiology., p. 502

31 Vanputte, C., Seeley, R., Regan, J., Russo.,A (2011). Antamony & Physiology., p. 502

32 https://heartfoundation.org.au/images/uploads/publications/Antioxidants-Position-Statement.pdf

33 https://heartfoundation.org.au/images/uploads/publications/Antioxidants-Position-Statement.pdf

34 Western Australia Mortality Database (2004-2013) Western Australia Hospital Morbidity Data System (2013-2014) Aetiological Fractions for Alcohol, Epidemiology Branch, WA Department of Health (2016)

36 Western Australia Mortality Database (2004-2013) Western Australia Hospital Morbidity Data System (2013-2014) Aetiological Fractions for Alcohol, Epidemiology Branch, WA Department of Health (2016)

37 Western Australia Mortality Database (2004-2013) Western Australia Hospital Morbidity Data System (2013-2014) Aetiological Fractions for Alcohol, Epidemiology Branch, WA Department of Health (2016)