Alcohol and the Cardiovascular System

Abstract

Excessive alcohol consumption has long been associated with cardiovascular disorders, including cardiomyopathy, hypertension, coronary artery disease, and stroke. However, recent evidence suggests that moderate alcohol intake can actually provide a measure of cardioprotection, particularly against coronary heart disease and ischemia-reperfusion injury. To explore the various dimensions of these opposing actions of alcohol, the National Institute on Alcohol Abuse and Alcoholism and the National Heart, Lung, and Blood Institute sponsored a state-of-the-art workshop on "Alcohol and the Cardiovascular System: Research Challenges and Opportunities" in Bethesda, Maryland, in May 2003. Speakers discussed the following topics: the epidemiology of alcohol and cardiovascular disease, clinical manifestations of alcohol, genetics of alcohol and cardiovascular disease, mechanisms underlying the molecular and cellular effects of alcohol, the application of new and emerging technology, and translation from discovery to therapeutic modalities of treatment. The panel concluded that future studies are needed to: 1) determine the role of genes and the environment in assessing mechanisms underlying the benefits of alcohol use and cardiovascular disease risk; 2) define the biological mechanisms underlying alcohol-induced peripheral vascular damage; 3) clarify the role of genetic variation in alcohol-metabolizing enzymes, genetic susceptibility, and pharmacogenomics in determining cardiovascular disease risk and effective treatment; 4) determine common mechanisms underlying alcohol-induced cardiovascular disease, such as oxidative stress and inflammation; 5) assess the role of insulin resistance, blood clotting, protein kinase C isoforms, and signal transduction mechanisms mediating alcohol's beneficial effects; and 6) explore the potential of stem cells in myocardial regeneration and repair in hearts damaged by alcohol.

Angiotensin II Type 1 Receptor Blockade Prevents Alcoholic Cardiomyopathy

“…These findings are similar to the clinical syndrome of ACM. 1,2 Importantly, we found that chronic alcohol-induced progressive LV dysfunction and remodeling are associated with parallel depression in cardiomyocyte function and increased resting myocyte length. By using freshly isolated single myocytes from the LV of chronic alcoholic dogs, we observed progressively depressed peak systolic [ levels.…”

“…AT 1 and AT 2 Receptor mRNA. LV myocyte total RNA was extracted by RNAqueous phenol-free total RNA isolation kit (Ambion, Austin, Tex) and treated with RNase-free DNase I (GIBCO BRL, Carlsbad, Calif).…”

“…1,2 However, the experimental evaluation of cardiac contractile performance as alcoholism progresses has been difficult in the past due to the lack of animal models that more closely resemble or mimic the human condition in terms of the amount and pattern of alcohol consumption. 2,[17][18][19] Although acute alcohol consumption has been demonstrated to have a direct cardiodepressant effect, 20 chronic alcohol intake has been variably reported to have no direct effect 21,22 or to impair LV performance. 18,19 Previous investigations with dogs administered alcohol for 6 months 21 or longer 19 demonstrated a clear impairment of LV relaxation and diastolic filling and an abnormal response to angiotensin infusion, which is consistent with our findings.…”

“…The underlying mechanisms through which alcohol produces this condition remain poorly understood. 1,2 Although the central role of the renin-angiotensin system (RAS) in the pathophysiology of heart failure and the importance of interrupting this pathway have been well established in both clinical and experimental studies, [3][4][5] the role of RAS in the development of alcoholic cardiomyopathy (ACM) has not been defined.…”

Risk factors for alcohol use among youth and main aspects of prevention programs

“…Unfortunately, weak interest of various sectors, media too, only retards the solving of alcohol-using problems. Another problem, often created by mass media, is that some conclusions of research are incorrectly interpreted, for example, that alcohol use reduces blood pressure and the risk of cardiovascular diseases (31).…”