Cardiovascular Effects of Alcohol.

Lecturer
Dr. Samir Zakhari -NIAAA
NIAAA/NIH, #402, MSC-7003
6000 Executive Blvd.
Bethesda, MD 20892-7003
(301) 443-0799
szakhari@willco.niaaa.nih.gov

Editor
Dr. Emanuel Rubin
Thomas Jefferson University
1020 Locust Street
Suite 279
Philadelphia, PA 19107-6799
(215) 955-5060
Emanuel.Rubin@mail.tju.edu

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Lecture Summary

Chronic alcohol abuse is associated with damage to multiple organs, including the brain, liver, pancreas, skeletal muscles, and the unborn fetus. The cardiovascular system is no exception. Indeed, alcohol abuse is associated with tremendous adverse consequences, including hypertension, cardiomyopathy, arrhythmias, and stroke. It also interacts with numerous cardiovascular medications, rendering them less effective or more toxic.

On the other hand, numerous epidemiological studies have shown that moderate drinking is associated with reduced risk of coronary artery disease (CAD). The objectives of this overview are to:

Describe the physiological and biochemical basis of cardiovascular function.
Illustrate the effects of acute and chronic alcohol consumption on various components of the cardiovascular system.
Discuss potential mechanisms by which moderate alcohol consumption may afford decreased risk of CAD.
Address alcohol's interaction with cardiovascular medications.

This outline attempts to convey concepts regarding the mechanisms by which the heart and blood vessels function. Therefore, the lecture is arranged into three main topics: heart, blood vessels, and blood. The review is not meant to be a comprehensive, in depth presentation of cardiovascular physiology, and pathological consequences of chronic alcohol abuse, rather, it gives a flavor of how alcohol interacts with components of the cardiovascular system. The reader may refer to numerous reviews that are listed with most of the slides.

Alcohol and the Heart: The focal point of the first part of the discussion is how alcohol decreases myocardial contractility and reduces cardiac energy. It also highlights alcohol-induced cardiomyopathy and gender differences in this effect. In addition, alcohol disturbs the initiation and conduction of impulses that maintain rhythmicity, leading to various types of myocardial arrhytmias, which could be fatal.

Alcohol and Blood Vessels: This section focuses on alcohol's effects on coronary arteries, which supply the heart itself with blood and energy sources, and the cerebrovascular circulation. Alcohol's effects on ischemic and hemorrhagic stroke are discussed.

Alcohol and Blood: This part focuses on the process of coagulation and fibrinolysis, processes that may explain the potential cardioprotective effects of moderate drinking. For a comprehensive book on alcohol's effects on the cardiovascular system, the reader may refer to: Alcohol and the Cardiovascular System, Zakhari S and Wassef M (eds), NIAAA research monograph 31, NIH Publication Number 96-4133, 1996.