Alcohol abuse raises risk of cardiac disease, study says

People who abuse alcohol have a higher risk of having a heart attack, heart failure or irregular heartbeat, according to a new study out of California.

Investigators from the University of California-San Francisco, Oregon Health & Sciences University and Staten Island University Hospital in New York examined data for more than 14.7 million adults who received ambulatory surgery, emergency care or inpatient care in California between 2005 and 2009. They found that a history of alcohol abuse raised the risk for several kinds of serious cardiovascular disease, including heart attacks.

The authors said they set out to address the common perception that low to moderate levels of alcohol benefit the heart. Indeed, they wrote, “the lay press often highlights the potential health benefits of alcohol consumption and in fact, those who think alcohol is heart healthy drink more.”

Their data suggest the opposite is true, they wrote.

“Alcohol in excess should not be considered cardioprotective, but rather cardiotoxic, contributing to heightened risk for all three major, yet distinct, cardiac adverse outcomes,” the authors wrote, referring to heart attacks, congestive heart failure and irregular heartbeats, or atrial fibrillation.

Editorialists Michael Criqui, M.D., and Isac Thomas, M.D., writing in the same issue of the Journal of the American College of Cardiology in which the California study was published, put it in stronger terms.

“Alcohol is a potentially addictive and dangerous drug, both for the cardiovascular system and multiple other organ systems,” they wrote. “The recent infatuation with the potential benefits of light-to-moderate drinking for (cardiovascular disease) protection appears to be based on observational and subtly confounded data, rather than on (randomized controlled trial) evidence, and perhaps on more than a little wishful thinking.”

Defining alcohol abuse

The latest study and many others use the terms “alcohol abuse” and “alcohol dependence.” These definitions are derived from responses to an interview known as the Alcohol Use Disorder and Associated Disabilities Schedule, which is part of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (AUDASIS-IV).

To receive a diagnosis of alcohol abuse, a person must meet at least one of four abuse criteria during a 12-month period. The four criteria are:

• Use of alcohol has resulted in a failure to fulfill major obligations at work, school or home, such as repeated absences or poor performance
• Recurrent use of alcohol in situations in which it is hazardous to do so, such as driving
• Recurrent alcohol-related legal problems
• Continuing to use alcohol despite recurrent social or interpersonal problems caused or aggravated by the effects of alcohol, such as arguments with a spouse or getting into fights

To receive a diagnosis of alcohol dependence, a person must meet three or more of seven dependence criteria in the previous 12 months, or any previous 12-month period. The seven criteria are:

• Tolerance, defined as a need for increased amounts of alcohol to achieve the desired effect or a diminished effect without using the same amount of alcohol
• Withdrawal, as defined by a variety of criteria, including insomnia, hand tremor, anxiety, hallucinations and nausea
• Using alcohol in larger amounts or over a longer period of time than intended
• Persistent desire or efforts to cut down on alcohol use
• Spending considerable time to obtain or use alcohol or recover from its effects
• Reducing or eliminating important social, occupational or recreational activities because of alcohol use
• Continuing to use alcohol despite knowing of a persistent physical or psychological problem that is likely to have been caused or exacerbated by alcohol use

For further reading

If you are concerned about your use of alcohol, or if the definitions of alcohol abuse or alcohol dependence seem familiar to you, Providence has many resources that can help. You can find a Providence provider here.

The study, “Alcohol Abuse and Cardiac Disease,” was published in the Journal of the American College of Cardiology. The associated editorial by Drs. Criqui and Thomas, “Alcohol Consumption and Cardiac Disease: Where Are We Now?,” was published in the same journal.