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Alcohol Heart, Diabetes and Lipids 201
Negative effects of increased alcohol
consumption
Hypertension and transient increase in BP
Endothelial dysfunction &oxidative stress
↑ Plasminogen Activator Inhibitor
↓ Fibrinolysis
↑ thrombus formation
Alcoholic cardiomyopathy
Alcohol and its metabolite acetaldehyde are cardio-
toxins. Myocardial depression is initially reversible
but, if sustained ,can lead to irreversible vacuoliza-
tion, mitochondrial abnormalities and fibrosis. The
amount of alcohol necessary to produce symptom-
atic cardiomyopathy in susceptible individuals is not
known but has been estimated to be six drinks(~4 oz
of pure ethanol)a day for 5 to 10yrs.Frequent binging
without heavy daily consumption may also be suffi-
cient to produce cardiac disease. Abstinence leads
to improvement in atleast 50% of patients with se-
vere symptoms, some of whom normalize their left
ventricular ejection fraction. In addition to its role in
Dilated Cardiomyopathy (DCM) heavy alcohol use is
associated with hypertension which can aggravate
DCM and may be refractory to treatment.
Alcohol and hypertension
The alcohol intake elevates the arterial pressure in
a dose dependent response. The rennin angiotensin
system might be involved in the mechanism that al-
cohol to induce hypertension. The increased plasma
rennin is caused by dehydration due to ethanol di-
uresis or to the inhibiting action of ethanol in the
aldosterone secretion. A reduction in the ingestion
of alcohol between heavy consumers significantly
reduces the systolic and diastolic arterial pressure.
Therefore the reduction of alcohol consumption must
be recommended as a lifestyle modification in heavy
drinkers.
Cardioprotective effects of low to moderate
alcohol consumption Alcohol and Diabetes
↑ HDL Regularly drinking a moderate amount of alcohol
could reduce the chances of developing diabetes
↑ A-I,A-II apolipoprotein
.Consuming alcohol three or four days a week is as-
↓ Level of oxidised LDL sociated with a reduced risk of developing diabetes
↓ CRP, Fibrinogen level a 27%reduction in men and a 32%reduction in women
↓ Platelet reactivity, aggregability compared with abstaining .Wine is considered par-
↑ Insulin sensitivity ticularly beneficial ,probably because it has chemi-
cal compounds that improve blood sugar balance.
Gin have the opposite effect along with other spirits
.Chances of getting hypoglycaemia are higher in di-
Cardio Diabetes Medicine
