Alcohol-Attributable Cardiovascular Diseases


Regular alcohol consumption increases the risk of hypertension in a dose-dependent association. Alcohol reduction improves blood pressure and should be an early suggestion to manage patients with hypertension. Reducing alcohol should be a key strategy for lowering blood pressure in hypertensive patients, to reduce the morbidity and mortality from hypertension. 

Alcohol-Related Cardiomyopathy 

Alcohol-related cardiomyopathy accounts for about one-third of all cardiomyopathy. The effects of alcohol differ between individuals, however, there is a dose and duration-dependent effect on left ventricular mass and diastolic dysfunction and for women, a reduced left ventricular ejection fraction. 

Cardiac Dysrhythmias 

Harmful use of alcohol is associated with the development of cardiac arrhythmia including in persons with normal cardiac function. Atrial fibrillation (AF) is the most common of the dysrhythmias seen in alcohol use and can affect those with structurally normal hearts. Dysrhythmias can also be a manifestation of alcohol cardiomyopathy. Sudden death in alcohol misuse (SUDAM) has recently been characterised in a case series, and alcohol may be an unrecognised contributing aetiology, probably secondary to associated QT interval prolongation.  

Assessment and Management of Alcohol-Related Cardiovascular Disorders 

Primary care and frontline critical care workers should have a high index of suspicion for underlying alcohol problems as a cause for cardiovascular complications such as cardiomyopathy and arrhythmias, even when patients present with other health conditions. Physicians treating persons with AUD where cardiovascular diseases are suspected should consider abstinence from alcohol as part of an intervention to treat these diseases and prevent further complications. 

Chapter Recommendation Grade of recommendation
22.4 A high index of suspicion for cardiovascular diseases such as dysrhythmia is indicated in persons with AUD, even without clinical sign and symptoms of cardiovascular diseases. An abstinence-focused treatment plan for alcohol use disorders is recommended for patients with alcohol use disorders to prevent the complication of cardiovascular diseases and improve clinical outcomes. B