Alcohol and Heart Disease

Does alcohol affect the heart?

Alcohol can hurt the heart, but it may also help the heart. Any alcoholic drink causes a small but measurable change in heart cell function. Too much alcohol over time can enlarge the heart and weaken the heart muscle. When this happens, the heart muscle cannot pump blood as well. Eventually, this can lead to heart failure, which means that the heart muscle cannot pump enough blood to meet the body's needs. Heavy drinking of alcohol is also a common cause of irregular and fast heartbeats, called atrial fibrillation.

However, small amounts of alcohol may help the heart. Drinking alcohol may lower the risk of heart attacks and death from heart and blood vessel disease in some groups of people. This may be because alcohol lowers cholesterol and blood pressure. However, alcohol also increases the risk of falls, car crashes, and some kinds of stroke. Eating a healthy diet, exercising, and quitting smoking are better choices for heart health than drinking alcohol.

Moderate drinking is the key. Moderate drinking means 1 drink a day for women and no more than 2 drinks a day for men. A drink equals 12 ounces of regular beer, 5 ounces of wine, or 1 and 1/2 ounces of 80-proof distilled spirits, such as whiskey or vodka. Keep in mind that if you are taking certain medicines, you should not be drinking any alcohol because the combination could damage your liver or change the effects of your medicines. Ask your healthcare provider about this.

Daily use of more than a moderate amount of alcohol can make the heart bigger and may be a cause of heart failure. Binge drinking (drinking more than 5 drinks in a row) can also hurt the heart. It is not known how much alcohol it takes over how long to cause heart disease.

How is heart disease diagnosed?

Your healthcare provider will ask about your symptoms and examine you. You may have some tests, such as:

• electrocardiogram (ECG), a recording of the electrical activity of the heart
• echocardiogram, a sound-wave test
• blood tests
• urine tests.

The usual signs of heart problems are abnormal rhythms, chest pain, and heart failure symptoms. Heart failure symptoms include enlargement of the heart, shortness of breath with exertion, waking up at night short of breath, and swelling in the legs and ankles. The liver may be enlarged.

How is it treated?

If you have heart disease related to alcohol, you must stop drinking completely. The good news is that if damage is not severe, the size of the heart may go back to normal and your heart may pump better when you stop drinking. If you keep drinking even moderately, your heart function will keep getting worse.

Ask yourself these questions to find out if you have a drinking problem:

• Have you ever felt you should stop drinking so much?
• Have people talked to you about how much or how often you drink?
• Have you ever felt bad or guilty about your drinking?
• Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

Any "yes" answer means that you should get help for your drinking. There are many places where you can get help, such as clinics, Alcoholics Anonymous, and support groups. Your healthcare provider can also help you quit drinking and recover from problems caused by alcohol.

Talk to your healthcare provider about your use of alcohol, particularly if you are taking medicines.