Alcohol and heart disease

The effects of alcohol on the heart, looking at the risks and also the potential benefits claimed by some researchers.

It’s the most important pump in the world.

Your heart is a pump that keeps blood moving around your body. It delivers oxygen and nutrients to all parts of you, and carries away unwanted carbon dioxide and waste products.

When your heart, the arteries around your heart or your other blood vessels are damaged, this pumping system doesn’t work properly. Such problems are collectively known as cardiovascular disease and lead to the death of 191,000 people a year, making this the UK’s biggest killer (1).

Long-term excessive drinking increases your risk of developing problems with your heart. Drinking within the government's lower risk guidelines is unlikely to cause damage and, if you’re over 45, may help protect the heart. It’s important to remember that you don’t need to drink much above the lower risk guidelines to undo any protective effect and start causing harm even if you are in this group.

Read on, as we debunk the myths and give you the facts about alcohol and the heart.

What is heart disease?

There are lots of different types of heart disease. Coronary heart disease is the most common type of heart disease and can lead to sudden death from a heart attack. It’s caused by the gradual build-up of fatty deposits on the walls of the arteries in your heart (the coronary arteries) on which blood clots may form. These deposits cause the artery to narrow, and make it harder for it to supply your heart muscle with the oxygen and nutrients which it needs to function normally.

What is a heart attack?

Heart attacks are the most common result of coronary heart disease. Someone has a heart attack when their coronary arteries become blocked. This stops blood supply to the heart’s muscles meaning it can’t get the oxygen it needs. Starved of oxygen, the heart can’t pump properly, and in severe cases it may effectively stop beating altogether which can kill you. Damage to the heart muscle can lead to heart failure – when your heart can no longer pump blood around your body normally. This leads to symptoms such as swelling of the ankles and shortness of breath which affect you for the rest of your life and often become progressively worse. Although there are drugs that can help limit the impact of heart failure, there isn't a cure at the moment (2).

Long-term, heavy drinking can lead to heart disease

Drinking more than the lower risk guidelines regularly and over a long period of time can increase your risk of developing heart disease. This is because, drinking at this level can:

  • Increase the risk of high blood pressure. Drinking excessive amounts of alcohol causes raised blood pressure which is one of the most important risk factors for having a heart attack or a stroke. Increases in your blood pressure can also be caused by weight gain from excessive drinking (3).
  • Heavy drinking weakens the heart muscle, which means the heart can’t pump blood as efficiently. It’s known as cardiomyopathy and can cause premature death, usually through heart failure (4). The heart may be enlarged (5)

Binge drinking can make your heart beat irregularly

The name Holiday Heart Syndrome was coined in 1978 (6) but it is misleading. People who have it certainly won’t be having a leisurely time. In fact they might feel like they are having a heart attack – characterised by severe pain in the centre of the chest. It gets its name because cases of the condition tend to increase around holiday times or after weekends, when people tend to drink more (7). 

Holiday Heart Syndrome tends to come on after episodes of heavy drinking – usually at least 15 units (about seven and a half pints of 4% beer or one and a half bottles of 13% wine).  If this happens, your heart starts to beat irregularly making you feel breathless. Your blood pressure changes, increasing your risk of a heart attack and sudden death.

Alcohol can have protective benefits for the heart – but only if you drink within the daily unit guidelines and are over 45

Research suggests that small amounts of alcohol can have a protective effect on your heart (8) (9). This benefit appears to be restricted to over 45-year-olds drinking well within the lower risk guidelines.

Scientists aren’t sure how alcohol has the protective effect but think there are two main mechanisms:

  1. Preventing artery damage. Alcohol appears to increase the level of ‘good’ cholesterol (HDL) in the blood. This reduces the amount of fatty deposit (atheroma) which narrows our arteries and makes them more likely to clog.
  2. Preventing blood clots (‘thrombosis’). Alcohol can help prevent the formation of blood clots which can close off the arteries, causing a heart attack. It reduces the stickiness of platelets so they are less ready to clump together to form clots. Small amounts of alcohol with a meal can reduce the sudden rise of a protein (fibrinogen) produced by the liver, which is involved in clot formation. 

Can alcohol ever be good for the heart?

More research is needed to show whether drinking red wine is “good for the heart”

Laboratory studies in animals suggest that antioxidants help to prevent thrombosis (10). Red wine has a high concentration of antioxidant substances called flavonoids. White alcoholic drinks, like vodka and cider, contain the least concentration of flavonoids. But other alcohols, such as beer, have nearly the same antioxidant effect as wine.

Much of the interest in red wine comes from the observation that the French (who have a long tradition of drinking red wine) often have healthy hearts and arteries despite typically having high-fat foods in their diet. But studies show that people who drink wine over other types of alcohol tend to live healthier lives, smoking less, drinking less and having a healthier diet. So these other factors, rather than the red wine, may in fact be responsible for their good health.

It’s not a good idea to start drinking alcohol to protect yourself against heart disease

Simply put, it’s just not worth it. With alcohol and the heart, it’s a benefit and risk trade off. So, for example, alcohol’s anti-clotting ability, potentially protective against heart attack, may increase the risk of haemorrhagic stroke (when a blood vessel bursts inside the brain), or bleeding within the brain. Beyond the daily unit guidelines, alcohol’s potential benefits on the heart are outweighed by its increased risks of developing other illnesses, such as liver disease or cancer.

There are safer ways to reduce your risk of developing heart disease. To keep your heart healthy, the British Heart Foundation (BHF) advises:

  • taking exercise
  • eating a healthy diet
  • being aware of dangers such as smoking, drinking, high blood pressure and stress.

Facts

  • Coronary heart disease causes around 80,000 deaths in the UK each year (11).
  • Drinking more than the lower risk guidelines can cause abnormal heart rhythms, high blood pressure, damage to the heart muscle and other diseases such as stroke, liver problems and some cancers (12)

Staying in control

Your GP can help you figure out if you should make any changes in your drinking, and offer help and advice along the way.

If you’re concerned about someone’s drinking, or your own, Drinkline runs a free, confidential helpline. Call 0800 917 8282.

For help, facts and lifestyle advice, contact the British Heart Foundation. Call their Heart Helpline on 0300 330 3311 or visit www.bhf.org.uk 

The Blood Pressure Association offers a range of information to help you take control of, or prevent, high blood pressure. Call their information line on 0845 241 0989 or visit www.bpassoc.org.uk

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References

Page updated: October 2014