The question of the effect of alcohol on heart and vessel diseases has been the subject of intense controversy in recent years. The consensus is now that moderate alcohol drinking is associated with reduced cardiovascular mortality, although the exact mechanism(s) by which alcohol is protective are still unclear. In contrast, chronic heavy drinking has been incriminated in the occurrence of atrial as well as ventricular arrhythmias in humans — an effect called "holiday heart" because it is often associated with binge drinking by healthy people, specifically during weekends. Studies in animals have shown varying and apparently contradictory effects of alcohol on cardiac rhythm and conduction, depending on the species, experimental model, and dose of alcohol. If given acutely to nonalcoholic animals, ethanol may even have antiarrhythmic properties.
Few human studies have specifically investigated the effect of alcohol on SCD. The hyperadrenergic state resulting from binge drinking and from withdrawal in alcoholics seems to be the main mechanism by which alcohol induces arrhythmias. In the British Regional Heart Study, the relative risk of SCD in heavy drinkers (>6 drinks per day) was twice as high as risk in occasional or light drinkers.26 However, the effect of binge drinking on SCD was more evident in men with no pre-existing CHD than in those with established CHD. In contrast, in the Honolulu Heart Pro-gram,27 the risk of SCD among healthy middle-aged men was positively related to blood pressure, serum cholesterol, smoking, and left ventricular hypertrophy, but inversely related to alcohol intake.
The effect of moderate social drinking on the risk of SCD in nonalcoholic subjects has been addressed in only one study. Investigators of the Physicians' Health Study assessed whether light-to-moderate alcohol drinkers apparently free of CHD at baseline have decreased risks of SCD.28 After controlling for multiple confounders, men who consumed two to four drinks per week or five to six drinks per week at baseline had significantly reduced risks of SCD by 60 to 80%, as compared with those who rarely or never consumed alcohol. Analyses were repeated after excluding deaths occurring during the first 4 years of follow-up (in order to exclude the possibility that some men who refrained from drinking at baseline did so because of early symptoms of heart diseases), and also using the updated measure of alcohol intake ascertained at year 7 to address potential misclassification in the baseline evaluation of alcohol drinking.28 These secondary analyses basically provided the same results and confirmed the potential protective effect of moderate drinking on the risk of SCD. Despite limitations (the selected nature of the cohort, an exclusively male study group, and lack of information on beverage types and drinking patterns), this study suggests that a significant part of the cardioprotective effect of moderate drinking is related to the prevention of SCD. Further research should be directed at understanding the mechanism(s) by which moderate alcohol drinking may prevent ventricular arrhythmias and SCD.
Current knowledge suggests that in CHD patients at risk of SCD, there is no reason not to allow moderate alcohol drinking. From a practical point of view, we advise patients to drink one or two drinks per day, preferably wine during the evening meal, and never before driving a car or performing dangerous work.
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Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.