Alcohol

1. ALCOHOL

2. WILLIAM SHAKESPEARE, OTHELLO
• O God, that men should put an enemy in their
mouths to steal away their brains! that we
should, with joy, pleasance revel and applause,
transform ourselves into beasts!

3. ALCOHOL HAS BEEN DIRECTLY LINKED TO
60 DIFFERENT MEDICAL CONDITIONS
AFFECTING DIFFERENT ORGAN SYSTEMS
• Alcohol has been part of human history for at least 10000 years.
Throughout much of that time, it has been used medicinally but has also
long been known to have detrimental effects. Alcohol has been directly
linked to 60 different medical conditions affecting different organ
systems. Diseases related to a high intake of alcohol include
stroke2, cardiomyopathy, several kinds of cancer, cirrhosis, and
pancreatitis, as well as accidents and suicide. Up to 4% of the total
current burden of global disease is attributable to alcohol. In most
disease states, there is a correlation between risk of pathology and
volume of alcohol consumed, although patterns of drinking can also
affect the burden of disease. There is a more complex relationship
between alcohol consumption and cardiovascular disease with possible
benefits as well as risks.

4. • Alcohol has complex physiological effects that can have both a positive and
negative impact on cardiovascular health depending on the volume
consumed, the pattern of consumption and the outcome under study. There
is good evidence that compared to the consumption of no alcohol,
moderate intake of alcohol is associated with a lower incidence and long
term risk from coronary artery disease (CAD). A large meta-analysis found
that this relationship is J shaped with the lowest risk in those consuming 20g
alcohol per day (<2 drinks) and with the risk rising steeply in those
consuming >70g per day. Another study found that the risk reduction from
regular moderate drinking may be between 30-50%. Proposed mechanisms
for this protective effect include the action of alcohol on lipids and
haemostatic factors. Moderate alcohol consumption is associated with an in
increase in high density lipoproteins (“good cholesterol”) which may be
responsible for a large part of the protective effect.

5. HEAVY DRINKING (>3 DRINKS PER DAY)
•
Heavy drinking (>3 drinks per day) is associated with diabetes mellitus,
coronary artery disease, ischaemic stroke, haemorrhagic stroke and
increased mortality after myocardial infarction. However the pattern of
drinking is vitally important with some studies suggesting that irregular
heavy drinking (”binge drinking”) is particularly harmful, even if the total
volume of alcohol consumed is low. In population studies the net benefit or
negative impact of alcohol on CAD depends on the pattern on drinking in
that population. This is unsurprising as heavy alcohol use is associated with
an increased propensity to clot, elevation of low density lipoproteins (“bad
cholesterol”) and a reduced threshold for ventricular fibrillation. Heavy
alcohol consumption is also a major cause of hypertension and therefore
associated with diseases such as stroke which are strongly related to
hypertension

6. • The short term effects of alcohol on cardiovascular health may be far
more harmful. Increased heart rate, electromechanical delay and
impaired fibrinolysis all occur within hours of moderate alcohol
consumption. However by 12-24 hours, moderate alcohol intake results
in transient improvement in endothelial function and fibrinolytic factors.
A recent meta-analysis examined the acute effect of alcohol on the risks
of myocardial infarction (MI), ischaemic stroke (IS) and haemorrhagic
stroke (HS).

7. • Clearly there are no randomised studies on the effects of alcohol on
cardiovascular disease, but rather observational studies examining
alcohol intake and these outcomes. The analysis included 9 studies on
MI, 9 on IS and 7 on HS. They found that in summary, alcohol intake is
associated with an immediately higher risk of MI, IS and HS but after 24
hours, there is a lower risk of MI and HS and within 1 week, there is a
lower risk of IS. Heavy drinking continues to confer a higher risk of MI,
IS and HS after 24 hours, consistent with the literature described above.

8. EUROPEAN SOCIETY OF CARDIOLOGY
•
Limit their alcohol intake to a maximum of one
glass/day for women (10 g of alcohol) or two
glasses/day for men (20 g of alcohol) to
obtain the lowest level of chronic
cardiovascular disease risk
•

9. RED WINE
• Protective due to the effect of polyphenols

10. FOLLOW THE SOURCE
• http://www.bcs.com/pages/news_full.asp?NewsID=19792470