Heavy Drinking May Damage the Heart Before Signs Appear, Study Finds
Markers in blood may help reveal developing heart problems and could serve as a screening tool to help detect hazardous effects caused by alcohol use.
During the holiday season, alcohol consumption tends to rise. But the American Heart Association (AHA) reminds us that too much drinking can take a serious toll on our health. Heavy consumption increases the risk of high blood pressure, obesity, stroke, breast cancer, liver disease, depression, suicide, accidents, and alcohol abuse, according to the AHA.
Research published in December in the Journal of the American Heart Association gives a clearer picture of how excessive drinking can weaken the heart. The study shows how ingesting excessive amounts of booze damages the structure and function of the heart — even before symptoms occur. This heart tissue damage may be identified through changes in specific blood biomarkers, according to the investigation results.
“Even though you may not experience symptoms right away, heavy drinking increases the risk of heart problems in the future,” says one of the study's authors, Olena Iakunchykova, a PhD candidate in community medicine at the University in Tromsø, the Arctic University of Norway. “By measuring the level of certain molecules in the blood we were able to show that heavy drinkers are much more likely to have subclinical [not observable] heart damage than people who drink moderately.”
What Is Moderate and Heavy Consumption?
The AHA defines moderate alcohol consumption as an average of one to two drinks per day for men and one drink per day for women. Beer, wine, and liquor can have varying amounts of alcohol, but in general, a drink is one 12-ounce regular beer, 4 ounces of wine, or 1.5 ounces of 80-proof spirits, such as bourbon, vodka, or gin.
Consume more than these amounts, and you may be entering heavy-drinking territory.
In this study, heavy or harmful drinking was defined as six or more drinks on one occasion; feeling hungover or drunk; needing a drink first thing in the morning; experiencing adverse consequences in one's personal life because of drinking; or having a family member or loved one who is concerned about the drinking behavior.
Scientists based their results on blood taken from a random sample of 2,479 adults in a general population living in northwest Russia. They included a separate group of 278 hospital patients with extreme alcohol problems. Participants ranged in age from 35 to 69.
On the basis of self-reported levels of alcohol consumption, the general population sample was categorized into harmful drinkers, hazardous drinkers, non-problem drinkers, and nondrinkers. Researchers treated the smaller group with alcohol issues separately in their analysis.
Warning Signs in the Blood
Iakunchykova and her colleagues focused on three vital measures, or biomarkers, of heart health:
- High-sensitivity troponin T, a protein that is released into the blood when the heart muscle is damaged. High levels of this protein are dispersed when a person experiences a heart attack, for example.
- N-terminal pro-B-type natriuretic peptide, a marker of heart wall stretch. This peptide (a chain of amino acids) plays a central role in the regulation of blood pressure, blood volume, and sodium balance.
- High-sensitivity C-reactive protein, a measure of inflammation used to evaluate the risk of developing coronary artery disease.
Investigators discovered that the group of hospital patients with severe alcohol problems had the highest levels of all three biomarkers compared with the non-problem drinkers in the general population. Their heart injury was 10.3 percent higher; their cardiac wall stretch was 46.7 percent higher; and their inflammation was 69.2 percent higher.
Among the general population group, the drinkers with harmful consumption patterns had a measure of cardiac wall stretch that was 31.5 percent higher compared with the non-problem drinkers.
“Our results suggest that people who drink heavily are creating higher than normal levels of inflammation in their bodies that have been linked to a wide range of health conditions including cardiovascular disease,” says Iakunchykova.
Predicting Trouble Ahead for Heavy Drinkers
Currently, the biomarkers analyzed in this study are used for diagnostic tests in individuals experiencing the symptoms of heart failure or heart attack.
Nieca Goldberg, MD, the director of the New York University Center for Women's Health, sees potential for these markers to be used in a clinical setting to evaluate heart muscle damage in patients who may have the patterns of heavy drinking but no immediate signs of heart trouble.
“I think it would be interesting to explore how we can take this from the research setting to the clinical setting where we actually take care of patients,” says Dr. Goldberg, who was not involved in the study.
If heart damage is caught early on before it gets too extensive, heart muscles have a chance to return to normal. “If you drink heavily for too long, the damage to the heart can be permanent,” she says.
Getting a Clearer Picture of Unhealthy Drinking
While this report adds to what we already know about the health consequences of heavy alcohol consumption, the authors recognize the study’s limitations. Data came from just one city in Russia. Because findings were based on a population largely of Eastern European descent, they cannot be generalizable to other races or ethnic populations. Also, information on drinking habits was self-reported, which can often be unreliable.
The investigators are now looking at ultrasound information collected from the same study to identify the precise sorts of heart damage associated with heavy and harmful drinking.
Given the results so far, Iakunchykova would like to see a review of earlier evidence suggesting that alcohol use may offer protection from heart disease. According to the Mayo Clinic, some past research has shown that red wine may help prevent damage to blood vessels.
“Although some protective effect of light alcohol consumption was found in some studies, many researchers believe that marginal benefit to the vessels is offset by larger damage to other organs of the body including heart itself,” she says.