Alcohol and the cardiovascular system
T. J. Regan
Division of Cardiovascular Diseases, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark 07103-2757.
Ethanol has long been recognized as a toxic agent that has acute and
chronic effects on cerebral and hepatic function. Over the past two decades
important influences on the cardiovascular system have been either
rediscovered or observed for the first time. The combined use of tobacco
cigarettes and alcohol appears to increase the risk of many of these
clinical abnormalities. While many individuals addicted to ethanol have
subclinical abnormalities of the heart, somewhat less than a majority
develop symptomatic cardiac problems. These include heart failure and
arrhythmias. In addition to supraventricular arrhythmias that often
normalize spontaneously, there is an increased incidence of sudden death
that peaks at about 50 years of age in the alcoholic population. A
significant degree of blood pressure elevation occurs in individuals who
abuse alcohol. This appears to be transient and is normalized in most
individuals during abstinence. The increased incidence of hemorrhagic and
nonhemorrhagic stroke in middle age also appears to decline when alcohol
abuse is interrupted. A preventive effect of mild to moderate drinking on
coronary artery disease is, at present, equivocal, largely due to the
question of appropriate controls.
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