ASH: Excessive Drinking Linked to Structural and Functional Heart Changes

By Peggy Peck
21 may b2008--Use this code to embed video on your website or blog:' name=embed_code>
NEW ORLEANS, May 20 -- The well-known cardiac benefits of red wine aside, too much alcohol can be bad for the heart, according to a study of Irish drinkers.The damage differs by gender, said Azra Mahmud, M.D., Ph.D., of St. James Hospital in Dublin, at the American Society of Hypertension meeting here. For women, consuming more than two stiff drinks daily may lead to big hearts, and for men, more than three drinks a day can lead to stiff ventricles and stiff arteries, she said.
Dr. Mahmud and colleagues studied 200 consecutive patients seen at her hypertension clinic for initial assessment of elevated blood pressure. On the basis of self reports, patients were classified as nondrinkers, moderate drinkers (one to 21 units of alcohol per week for men and one to 14 for women), or excessive drinkers (more than 21 units for men and more than 14 for women).
Approximately 10% of the women in the study and 35% of the men were excessive drinkers and about 20% of men and women were nondrinkers, she said.
The patients were assessed with echocardiography with tissue Doppler imaging, and arterial stiffness was measured with pulse-wave velocity and augmentation index.
Blood pressure was measured with a digital oscillometric monitor after a supine rest of 15 minutes and also by 24-hour ambulatory blood pressure monitoring.
Laboratory measurements included fasting glucose and lipids, serum creatinine, and liver enzymes.
Among men, there was a linear relationship between alcohol intake and increasing aortic systolic and diastolic pressure, augmentation index, pulse-wave velocity, and indices of diastolic function (P <0.05 versus non-drinkers). "There was evidence of this effect even among men who were moderate drinkers," she said.
Women had no evidence of these effects even among heavy drinkers, she said, but there was "evidence of direct cardiac toxicity as there was a dose-response relationship between alcohol intake and thickening of the left ventricular septal (P<0.05) and posterior wall thickness and generally very high levels of left ventricular mass (P<0.01)."
Moreover, there was a tendency toward a slight decrease in left ventricular function -- 58% versus 65% among women who were non-drinkers. So while the ejection fraction was still normal, "it was clearly trending in the wrong direction."
Moreover, Dr. Mahmud said the changes observed in drinkers were "what we would expect to see in older people who have a long history -- 10 years or more -- of hypertension, not what we would expect in a younger population with new onset hypertension."
The mean age of women who were heavy drinkers was 42, and the mean age of the men who were heavy drinkers was 28.
She said she decided to investigate the relationship between alcohol intake and hypertension because there has been a great deal of interest in the "beneficial effect of red wine on coronary artery disease and that message has resonated with the public."
Ireland has been enjoying an economic boon since the 1990s. With prosperity has come "a great interest in wine and wine consumption and I have been observing what appears to be an increase in binge drinking."
The study was investigator initiated and funded. Dr. Mahmud disclosed no financial conflicts.
Primary source: American Society of HypertensionSource reference:Mahmud A, et al "The demon drink, deleterious effects of alcohol on the heart and blood vessels in hypertension" ASH Meeting 2008; Abstract P80.