The Greater Risk of Alcoholic Cardiomyopathy and Myopathy in Women Compared With Men

Urbano-Márquez, Á; Estruch, Ramón; Fernández-Solà, J; Nicolás, José Ma; Paré, Juan C.; Rubin, Emanuel

doi:10.1001/jama.1995.03530020067034

Cited by 265 publications

(109 citation statements)

References 36 publications

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“…Women absorb and metabolize alcohol differently than men 33 and women seem to be more sensitive than men to the toxic effects of alcohol on cardiac function, developing alcoholic cardiomyopathy with a lower total lifetime dose of alcohol compared with men. 734 Consistent with these findings, our study shows associations between alcohol intake and subclinical changes in cardiac structure in both sexes; although only among women increasing alcohol intake was associated with mild reduction of ventricular systolic function. In consequence, this study gives strength to the differences in the sensitivity of toxic alcohol effects by sex, which is in agreement with the international recommendations for a lower threshold of alcohol consumption in women compared to men.…”

Section: Figuresupporting

confidence: 88%

Relationship Between Alcohol Consumption and Cardiac Structure and Function in the Elderly

Gonçalves

Jhund

Claggett

et al. 2015

Circ: Cardiovascular Imaging

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Background Excessive alcohol consumption is associated with cardiomyopathy, but the influence of moderate alcohol use on cardiac structure and function is largely unknown. Methods and Results We studied 4466 participants from visit 5 of the Atherosclerosis Risk in Communities (ARIC) Study (76±5 years and 60% women) who underwent transthoracic echocardiography, excluding former drinkers and those with significant valvular disease. Participants were classified into 4 categories based on self-reported alcohol intake: non-drinkers, drinkers of up to 7 drinks per week, ≥7 to 14 and ≥ 14 drinks per week. We related alcohol intake to measures of cardiac structure and function, stratified by sex, and fully adjusted for covariates. In both genders, increasing alcohol intake was associated with larger left ventricular (LV) diastolic and systolic diameters and larger left atrial diameter (p values <0.05). In men, increasing alcohol intake was associated with greater LV mass (8.2 ± 3.8 g per consumption category, p = 0.029) and higher E/E’ ratio (0.82±0.33 per consumption category, p= 0.014). In women, increasing alcohol intake was associated with lower LV ejection fraction (−1.9% ± 0.6% per consumption category, p=0.002) and a tendency for worse LV global longitudinal strain (0.45% ±0.25% per consumption category, p=0.07). Conclusions In an elderly community-based population, increasing alcohol intake is associated with subtle alterations in cardiac structure and function, with women appearing more susceptible than men to the cardiotoxic effects of alcohol.

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Section: Figuresupporting

confidence: 88%

Relationship Between Alcohol Consumption and Cardiac Structure and Function in the Elderly

Gonçalves

Jhund

Claggett

et al. 2015

Circ: Cardiovascular Imaging

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“…These results have important clinical implications given evidence that alcohol use in women is increasing [3] and that women experience more adverse health consequences related to alcohol use [4–7]. Operant procedures that incorporate both appetitive and consummatory parameters will be useful in identifying individual differences in AUD and determining if treatments should be targeted at different phases of the treatment process depending on whether reducing craving or consumption is the treatment goal.…”

Section: Discussionmentioning

confidence: 99%

“…For example, compared to older cohorts, younger cohorts of women report a higher percentage of frequent binge drinking while these percentages have decreased in younger cohorts of men [3]. These findings are concerning given that women are more susceptible to negative health consequences associated with alcohol use [4–7]. …”

Section: Introductionmentioning

confidence: 99%

Female Sprague-Dawley rats display greater appetitive and consummatory responses to alcohol

Nieto

Kosten

2017

Behavioural Brain Research

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The narrowing of the gender gap in alcohol drinking patterns is a concern because women are more susceptible to adverse health consequences of alcohol use. Animal models of alcohol-seeking and –consuming are useful to delineate sex differences to test for effective sex-specific pharmacological treatments. We investigated potential sex differences in appetitive and consummatory responses to alcohol. Appetitive behaviors included numbers of head entries into the dipper access area and active lever presses. Consummatory behaviors included number of reinforcers delivered and consumed. Male and female Sprague-Dawley rats were placed on an overnight alcohol (10%) drinking schedule and trained to lever press for alcohol (10% solution). Separate groups of male and female animals had access to water overnight and were trained to lever press for sucrose (3% solution). Tests were conducted under a progressive ratio schedule of reinforcement. Alcohol-responding females demonstrated higher alcohol intake overnight and showed greater appetitive and consummatory responses compared to males. Similar sex differences were seen in the sucrose group. Effect sizes indicated greater sex differences in consummatory measures in the alcohol vs. sucrose groups. Conversely, greater sex differences in appetitive behaviors were observed in the sucrose vs. alcohol groups. Overall, the magnitude of the sex differences was stronger for appetitive behaviors compared to consummatory behaviors. Findings of quantitative sex differences in appetitive and consummatory behaviors for alcohol and for the natural reinforcer, sucrose, suggest this procedure is useful to assess efficacy of sex-specific treatments aimed at reducing appetitive and consummatory responses to alcohol.

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“…Ethanol ingestion is toxic for muscle and leads to the rapid appearance of ultrastructural changes [11]. Furthermore, women seem to be at higher risk of alcoholic cardiomyopathy and myopathy than men [12]. In our study, the discrepancy in the percentage of patients with increased CPK level observed between men and women is a possible argument for this fact.…”

Section: Discussionmentioning

confidence: 60%

Evolution of Metabolic Abnormalities in Alcoholic Patients during Withdrawal

Vandemergel

Simon

2015

Journal of Addiction

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Chronic alcohol intoxication is accompanied by metabolic abnormalities. Evolution during the early withdrawal period has been poorly investigated. The aim of this study was to determine the evolution of metabolic parameters during alcohol withdrawal. Patients and Methods. Thirty-three patients admitted in our department for alcohol withdrawal were prospectively included. Results. Baseline hypophosphatemia was found in 24% of cases. FEPO4 was reduced from 14.2 ± 9% at baseline to 7.3 ± 4.2% at day 3 (P < 0.01). FEPO4 inversely correlated with albuminemia (rs = −0.41, P = 0.01). CPK level was 124 ± 104 IU/L in men and 145 ± 85 IU/L in women (nl < 308 and <192 IU/L, resp.), 7% and 28% of patients having a CPK level >nl, respectively. No correlation was found between the sodium and CPK levels (P = 0.75) nor between the CPK level and the amount of alcohol ingested (rs = 0.084, P = 0.097). Baseline urate level was elevated and returned to normal after three days. Baseline magnesium concentration was normal and stable over time. Conclusion. Chronic alcohol intoxication was accompanied by phosphaturia, rapidly reversible after alcohol withdrawal and inversely correlated with albuminemia, slight hyponatremia, low levels of 25 hydroxy vitamin D, elevated CPK level in about 30% of women, and hyperuricemia with rapid normalization.

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The Greater Risk of Alcoholic Cardiomyopathy and Myopathy in Women Compared With Men

Cited by 265 publications

References 36 publications

Relationship Between Alcohol Consumption and Cardiac Structure and Function in the Elderly

Relationship Between Alcohol Consumption and Cardiac Structure and Function in the Elderly

Female Sprague-Dawley rats display greater appetitive and consummatory responses to alcohol

Evolution of Metabolic Abnormalities in Alcoholic Patients during Withdrawal

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