February, which is American Heart Month and includes Valentine’s Day, serves as a good time to review the ways that alcohol misuse can damage a most vital organ—the heart.
Research has demonstrated that long-term heavy drinking weakens the heart muscle, causing a disease called alcohol-associated cardiomyopathy, in which the left ventricle of the weakened heart dilates, stretches out, and cannot contract effectively. Consequently, the heart cannot pump sufficiently, impairing the supply of blood and oxygen within the body (known as ischemia). This impaired blood flow can cause severe organ and tissue damage and can even lead to heart failure. The symptoms of alcohol-associated cardiomyopathy include shortness of breath, fatigue, swollen legs and feet, and irregular heartbeat.
Alcohol misuse can also lead to high blood pressure (also called hypertension). Heavy alcohol consumption triggers the release of certain stress hormones that constrict blood vessels and elevate blood pressure. In addition, alcohol may affect the function of the muscles within the blood vessels, another factor associated with hypertension.
Research has shown that acute alcohol misuse, such as binge drinking, as well as long-term alcohol misuse can affect how quickly the heart beats. The heart depends on an internal pacemaker system to keep it pumping consistently and at the right speed. Alcohol can disturb this pacemaker system, causing arrythmia, a condition in which the heart beats too rapidly, or irregularly.
Alcohol misuse is also associated with atrial fibrillation (AF). According to the National Heart, Lung, and Blood Institute (NHLBI), AF causes the heart to beat faster than normal, leading to heart palpitations, chest pain, or fatigue. In a study of 100 patients diagnosed with AF, the likelihood of an episode of AF increased for several hours after alcohol consumption. In another study of patients with AF, abstaining from alcohol decreased the incidence of AF compared to a control group.
National Institute on Alcohol Abuse and Alcoholism-supported research will continue to investigate the pernicious damage of alcohol misuse on the heart. Meanwhile, American Heart Month is another opportunity to examine your relationship with alcohol. For tips and strategies for making a change, see Rethinking Drinking. Materials for American Heart Month are available through NHLBI.
References:
Piano, M.R. Alcohol’s effects on the cardiovascular system. Alcohol Research: Current Reviews 38(2):219–241, 2017. PMID: 28988575
Cleveland Clinic. Alcoholic Cardiomyopathy. Available at: https://my.clevelandclinic.org/health/diseases/21994-alcoholic-cardiomyopathy. Accessed January 20, 2022.
Day, E.; and Rudd, J.H.F. Alcohol use disorders and the heart. Addiction. 114(9):1670-1678, 2019. Epub 2019 Jul 15. PMID: 31309639
Farinelli, L.A.; Piacentino, D.; Browning, B.D.; Brewer, B.B.; and Leggio, L. Cardiovascular consequences of excessive alcohol drinking via electrocardiogram: A systematic review. Journal of Addictions Nursing 32(1):39–45, 2021. PMID: 33646717
Voskoboinik, A; Kalman, J.M.; De Silva, A.; Nicholls, T.; Costello, B.; Nanayakkara, S.; Prabhu, S.; Stub, D.; Azzopardi, S.; Vizi, D.; Wong, G.; Nalliah, C.; Sugumar, H.; Wong, M.; Kotschet, E.; Kaye, D.; Taylor, A.J.; and Kistler, P.M. Alcohol abstinence in drinkers with atrial fibrillation. New England Journal of Medicine 382(1):20–28, 2020. PMID: 31893513
NHLBI. Atrial Fibrillation. Available at: https://www.nhlbi.nih.gov/health-topics/atrial-fibrillation. Accessed October 18, 2021.
Marcus, G.M.; Vittinghoff, E.; Whitman, I.R.; Joyce, S.; Yang, V.; Nah, G.; Gerstenfeld, E.P.; Moss, J.D.; Lee, R.J.; Lee, B.K.; Tseng, Z.H.; Vedantham, V.; Olgin, J.E.; Scheinman, M.M.; Hsia, H.; Gladstone, R.; Fan, S.; Lee, E.; Fang, C.; Ogomori, K.; Fatch, R.; and Hahn, J.A. Acute consumption of alcohol and discrete atrial fibrillation events. Annals of Internal Medicine 174(11):1503–1509, 2021. Epub 2021 Aug 31. PMID: 34461028
This article first appeared in NIAAA Spectrum.
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