Coronary heart disease (CHD) causes approximately 80 000 deaths in the UK each year, and drinking over the advised limits has been linked with heart problems. Examples include heart arrhythmias, hypertension, damage to the myocardium such as hypertrophic cardiomyopathy, stroke, liver problems and even some cancers (Drinkaware, 2016). Long-term excessive drinking also causes an increased risk of cardiovascular disease—the biggest killer in the UK with 191 000 deaths a year (Drinkaware, 2016).
They say it's good for you…
Newspapers previously caused a stir when claiming that alcohol may in fact be good for your heart. This has been misinterpreted by many to indicate that it is entirely safe to drink alcohol. However, no amount of alcohol is entirely safe, given the well documented effects it has on physical and mental health—but drinking within the low-risk guidelines is unlikely to cause much damage, and if someone is over 45, alcohol may in fact help protect the heart (Drinkaware, 2016). It is very important not to mistake this to mean that someone's entire physical and mental health will be benefitted, and to be aware that if there is indeed any potential benefit, this is quickly undone if the alcohol consumption exceeds the low-risk guidelines.
The truth is…
Drinkaware (2016) has documented that drinking above the lower risk guidelines on a regular basis and over a long period of time can increase the risk of developing cardiovascular disease. This is mostly because drinking at this level causes hypertension, the most important risk factor for stroke and heart attack. Hypertension may also be caused by weight gain, which is also associated with this level of alcohol consumption. Furthermore, it leads to weakening of the myocardium, causing left-ventricular hypertrophy, which increases the chance of sudden death by cardiac arrest because of an increased risk of arrhythmia such as ventricular fibrillation. The increased risk of heart failure is also prevalent owing to cardiomyopathy. This is caused by inefficiency in cardiac output because of the dysfunctional myocardium.
Drinkaware (2016) states that scientists believe a small amount of alcohol in those above the age of 45 can cause a protective effect via two main mechanisms. These are: preventing artery damage by increasing the level of ‘good’ cholesterol (high-density lipoprotein (HDL)) in the blood, reducing atherosclerosis; and by preventing blood clot formation as a result of reducing the ease at which platelets can clump together to form a clot.
A health lifestyle is key…
It has been eluded to that red wine may be ‘good for the heart’. There is no research to suggest that this statement can be taken as fact. Lab studies carried out on animals suggest that antioxidants help to prevent thrombosis and that red wine has a high concentration of antioxidant substances known as flavonoids.
Studies show that beer had nearly the same antioxidant effect as wine. The interest in red wine originates from the French having healthy hearts despite a diet high in fats, and who are known to drink red wine by tradition. However, Drinkaware (2016) states that those in the studies who drink wine also have much healthier lifestyles—in general drinking less alcohol, exercising more, smoking less, etc. This would probably be why they have healthy hearts—not the isolated fact that they drink wine.
Risks outweigh benefits…
Alcohol therefore carries potentially minor benefits in some people, but major risks in all people. Alcohol's anti-clotting ability for example may well prevent a clot forming to cause a heart attack, but may in fact cause a haemorrhagic stroke. Alcohol's potential benefits are outweighed by its increased risks of developing other illnesses such as liver disease or cancer (Drinkaware, 2016). The British Heart Foundation (BHF) advises that in order to keep the heart healthy, instead of drinking any alcohol to: exercise, eat healthily, and be aware of the dangers of smoking, drinking, high blood pressure and stress (BHF, 2018).
In response to new alcohol guidelines by Dame Sally Davies and chief medical officers in 2016, Dr Mike Knapton, Associate Medical Director for the BHF said:
‘This consultation aims to clarify how the findings of research can be effectively presented and communicated to the public in a way that enables them to make informed decisions on the likely impact of personal alcohol consumption on their overall health. Although very low levels of alcohol may have some protective effects against coronary heart disease, this is more than outweighed by the adverse effects of alcohol on other organs. The BHF has never advised anyone to take up drinking to protect their heart. There are much better ways of achieving this through exercise, diet, not smoking and attention to risk factors such as high blood pressure and cholesterol levels.’ (BHF, 2016).
There is an increased risk of arrhythmia caused by binge drinking episodes. Not only can drinking lead to a faster heart rate, but atrial fibrillation is also commonly linked to binge drinking, and even paroxysmal ventricular tachycardia has been associated with alcohol consumption.
A life-threatening syndrome…
The Drinkaware (2016) web page covering the effects of alcohol on heart notes that the term, Holiday Heart Syndrome was coined in 1978 which links the effects of binge drinking to cause of arrhythmia. A study that performed analysis of electrocardiograms (ECGs) following resolution of arrhythmias in patients who have consumed a large quantity of alcohol show significant prolongation of the PR, QRS, and QT intervals compared with patients who experienced arrhythmias in the absence of alcohol consumption (Aasebø et al, 2007).
The term holiday heart syndrome is certainly misleading, as the arrhythmias caused as a result of drinking alcohol can be life-threatening. The condition got its name because of the increase of cases of its kind on weekends or during the summer holiday season. Drinkaware (2016) states that holiday heart syndrome can come on after episodes of heavy drinking, usually after approximately 15 units (1.5 bottles of 13% wine or 7.5 pints of beer). The heart would begin to beat irregularly, causing breathlessness and chest pain. The blood pressure would be altered and the resulting hypertension could cause a heart attack or sudden death (Drinkaware, 2016).
Take-home message…
Current guidelines state that men and women should not drink more than 14 units of alcohol each week and that several alcohol-free days each week should be had (BHF, 2018). Alcohol should be avoided for 48 hours or more if someone drinks too much, as the body will need to recover.