Alcohol and Heart Disease

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. The heart muscle can't pump blood as well. Eventually, this can lead to heart failure. Alcohol is also a common cause of irregular and fast heartbeats, called atrial fibrillation.

Does alcohol help or hurt the heart and cardiovascular system? How much is too much? Is there a "right" amount? Enough information is now available to help sort out at least some answers.

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 it 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 up to 2 drinks 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.

Daily use of more than these amounts 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) also hurts the heart. It is not known how much alcohol it takes over how long to cause heart disease.

Your health care 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 your 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.

The outlook for someone with heart disease related to alcohol is very poor unless the person stops drinking completely. The good news is that if damage is not severe, the size of the heart may return to normal and heart function improve in people who stop drinking. The heart function of people who continue to drink even moderately continues to get 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 for you to get help, such as clinics, Alcoholics Anonymous, and support groups. Your health care provider can help you quit drinking and recover from problems caused by alcohol.