Skip to main content
SpringerLink
Log in

Alcohol and the Cardiovascular System: Implications for Behavioral Medicine

  • Reference work entry
  • First Online:
Handbook of Cardiovascular Behavioral Medicine

  • 734 Accesses

Abstract

Alcohol is the second most widely consumed drug worldwide, second only to caffeine. The social and beneficial effects of moderate consumption are well documented, and alcohol use is unlikely to decline in the general population. Excessive consumption of alcohol has deleterious effects on the central nervous system, skeletal muscle, and cardiac muscle. Alcohol consumption above three standard drinks per day therefore may lead to cardiovascular complications. Consumption above this level increases the prevalence of hypertension and stroke. These effects can in turn aggravate the development of coronary artery disease. Alcohol’s effects on nervous system tissue can increase the risk for cardiac arrhythmias in predisposed individuals, and its effects on muscle tissue can contribute to dilated cardiomyopathy. Heavy alcohol consumption is more likely to occur in some persons, and those with a positive family history of alcoholism are at significantly increased risk compared to persons with no family history. In addition, a propensity to heavy drinking is exaggerated in persons exposed to greater degrees of stress during childhood and adolescence. Cardiovascular disorders are associated with prolonged heavy intake of alcohol, and persons with familial risk for alcoholism or who are exposed to stress during development are more likely to develop such complications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 549.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Agarwal DP (2002) Cardioprotective effects of light-moderate consumption of alcohol: a review of putative mechanisms. Alcohol Alcohol 37:409–415

    Article  PubMed  Google Scholar 

  2. Anderson P, Cremona A, Paton A et al (1993) The risk of alcohol. Addiction 88:1493–1508

    Article  PubMed  Google Scholar 

  3. Babor TF, Hofmann M, Delboca FK et al (1992) Types of alcoholics, I. Evidence for an empirically derived typology based on indicators of vulnerability and severity. Arch Gen Psychiatry 49:599–608

    Article  PubMed  Google Scholar 

  4. Babor TF, Higgins-Biddle JC, Saunders JB et al (2001) The alcohol use disorders identification test: guidelines for use in primary care. World Health Organization: Department of Mental Health and Substance Dependence, Geneva

    Google Scholar 

  5. Batty G, Lewars H, Emslie C et al (2009) Internationally recognized guidelines for ‘sensible’alcohol consumption: is exceeding them actually detrimental to health and social circumstances? Evidence from a population-based cohort study. J Public Health 31:360

    Article  Google Scholar 

  6. Beghi E, Boglium G, Cosso P et al (1995) Stroke and alcohol intake in a hospital population. A case-control study. Stroke 26:1691–1696

    Article  PubMed  Google Scholar 

  7. Bernardy NC, King AC, Parsons OA et al (1996) Altered cortisol response in sober alcoholics: an examination of contributing factors. Alcohol 13:493–498

    Article  PubMed  Google Scholar 

  8. Bohman M, Sigvardsson S, Cloninger CR (1981) Maternal inheritance of alcohol abuse. Cross-fostering analysis of adopted women. Arch Gen Psychiatry 38:965–969

    Article  PubMed  Google Scholar 

  9. Britton KA, Gaziano JM, Sesso HD et al (2009) Relation of alcohol consumption and coronary heart disease in hypertensive male physicians (from the Physicians’ health study). Am J Cardiol 104:932–935

    Article  PubMed  PubMed Central  Google Scholar 

  10. Brooks JO, Hoblyn JC, Woodard SA et al (2009) Corticolimbic metabolic dysregulation in euthymic older adults with bipolar disorder. J Psychiatr Res 43:497–502

    Article  PubMed  Google Scholar 

  11. Ceccanti M, Sasso G, Nocente R et al (2006) Hypertension in early alcohol withdrawal in chronic alcoholics. Alcohol Alcohol 41:5

    Article  PubMed  Google Scholar 

  12. Cobb S, Rose RM (1973) Hypertension, peptic ulcer, and diabetes in air traffic controllers. J Am Med Assoc 224:489–492

    Article  Google Scholar 

  13. Costanzo PR, Malone PS, Belsky D et al (2007) Longitudinal differences in alcohol use in early adulthood. J Stud Alcohol Drugs 68:727–737

    Article  PubMed  Google Scholar 

  14. Crews FT, Nixon K (2009) Mechanisms of neurodegeneration and regeneration in alcoholism. Alcohol Alcohol 44:115–127

    Article  PubMed  Google Scholar 

  15. Criqui MH (1998) Do known cardiovascular risk factors mediate the effect of alcohol on cardiovascular disease? Novartis Found Symp 216:159–167; discussion 167–172

    PubMed  Google Scholar 

  16. Danaei G, Ding EL, Mozaffarian D et al (2009) The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med 6:e1000058

    Article  PubMed  PubMed Central  Google Scholar 

  17. Dawson DA (2000) The link between family history and early onset alcoholism: earlier initiation of drinking or more rapid development of dependence? J Stud Alcohol 61:637–646

    Article  PubMed  Google Scholar 

  18. Dawson DA, Grant BF, Ruan WJ (2005) The association between stress and drinking: modifying effects of gender and vulnerability. Alcohol Alcohol 40:453–460

    Article  PubMed  Google Scholar 

  19. De Bellis MD (2002) Developmental traumatology: a contributory mechanism for alcohol and substance use disorders. Psychoneuroendocrinology 27:155–170

    Article  PubMed  Google Scholar 

  20. De Lorimier A (2000) Alcohol, wine, and health. Am J Surg 180:357–361

    Article  PubMed  Google Scholar 

  21. Djousse L, Levy D, Benjamin EJ et al (2004) Long-term alcohol consumption and the risk of atrial fibrillation in the Framingham study. Am J Cardiol 93:710–713

    Article  PubMed  Google Scholar 

  22. Dohrenwend BP (2000) The role of adversity and stress in psychopathology: some evidence and its implications for theory and research. J Health Soc Behav 41:1–19

    Article  PubMed  Google Scholar 

  23. Enger SC, Hjermann I, Foss OP et al (1979) High density lipoprotein cholesterol and myocardial infarction or sudden coronary death: a prospective case-control study in middle-aged men of the Oslo study. Artery 5:170–181

    PubMed  Google Scholar 

  24. Engstrom G, Hedblad B, Janzon L et al (1999) Ventricular arrhythmias during 24-h ambulatory ECG recording: incidence, risk factors and prognosis in men with and without a history of cardiovascular disease. J Intern Med 246:363–372

    Article  PubMed  Google Scholar 

  25. Ewing JA (1984) Detecting alcoholism. The CAGE questionnaire. JAMA 252:1905–1907

    Article  PubMed  Google Scholar 

  26. Feigin VL, Rinkel GJ, Lawes CM et al (2005) Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies. Stroke 36:2773–2780

    Article  PubMed  Google Scholar 

  27. Fernandez-Sola J, Estruch R, Grau JM et al (1994) The relation of alcoholic myopathy to cardiomyopathy. Ann Intern Med 120:529–536

    Article  PubMed  Google Scholar 

  28. Fernandez-Sola J, Estruch R, Nicolas JM et al (1997) Comparison of alcoholic cardiomyopathy in women versus men. Am J Cardiol 80:481–485

    Article  PubMed  Google Scholar 

  29. Fernandez-Solà J, Fatjo F, Sacanella E et al (2006) Evidence of apoptosis in alcoholic cardiomyopathy. Hum Pathol 37:1100–1110

    Article  PubMed  Google Scholar 

  30. Ferreira MP, Weems MK (2008) Alcohol consumption by aging adults in the United States: health benefits and detriments. J Am Diet Assoc 108:1668–1676

    Article  PubMed  Google Scholar 

  31. Foerster M, Marques-Vidal P, Gmel G et al (2009) Alcohol drinking and cardiovascular risk in a population with high mean alcohol consumption. Am J Cardiol 103:361–368

    Article  PubMed  Google Scholar 

  32. Gaziano JM, Buring JE (1998) Alcohol intake, lipids and risks of myocardial infarction. Novartis Found Symp 216:86–95; discussion 95–110

    PubMed  Google Scholar 

  33. Hannuksela ML, Ramet ME, Nissinen AE et al (2004) Effects of ethanol on lipids and atherosclerosis. Pathophysiology 10:93–103

    Article  PubMed  Google Scholar 

  34. Hansson A, Madsen-Hardig B, Olsson SB (2004) Arrhythmia-provoking factors and symptoms at the onset of paroxysmal atrial fibrillation: a study based on interviews with 100 patients seeking hospital assistance. BMC Cardiovasc Disord 4(1):1–9. [Serial on the Internet]

    Article  Google Scholar 

  35. Hines LM, Hunter DJ, Stampfer MJ et al (2005) Alcohol consumption and high-density lipoprotein levels: the effect of ADH1C genotype, gender and menopausal status. Atherosclerosis 182:293–300

    Article  PubMed  Google Scholar 

  36. Hyman M, Zimmerman M, Gurioli C et al (1980) Drinkers, drinking, and alcohol-related mortality and hospitalizations: a statistical compendium. Publications Division, Center of Alcohol Studies, Rutgers University, New Brunswick

    Google Scholar 

  37. Kajander OA, Kupari M, Perola M et al (2001) Testing genetic susceptibility loci for alcoholic heart muscle disease. Alcohol Clin Exp Res 25:1409–1413

    Article  PubMed  Google Scholar 

  38. Katano S, Nakamura Y, Nakamura A et al (2010) Relationship among physical activity, smoking, drinking and clustering of the metabolic syndrome diagnostic components. J Atheroscler Thromb 17:644–650

    Article  PubMed  Google Scholar 

  39. Kawano Y, Abe H, Takishita S et al (1998) Effects of alcohol restriction on 24-hour ambulatory blood pressure in Japanese men with hypertension. Am J Med 105:307–311

    Article  PubMed  Google Scholar 

  40. Kinder LS, Bryson CL, Sun H et al (2009) Alcohol screening scores and all-cause mortality in male veterans affairs patients. J Stud Alcohol Drugs 70:253–260

    Article  PubMed  Google Scholar 

  41. King AC, Errico AL, Parsons OA et al (1991) Blood pressure dysregulation associated with alcohol withdrawal. Alcohol Clin Exp Res 15:478–482

    Article  PubMed  Google Scholar 

  42. King AC, Bernardy NC, Parsons OA et al (1996) Hemodynamic alterations in alcohol-related transitory hypertension. Alcohol 13:387–393

    Article  PubMed  Google Scholar 

  43. Klatsky AL (1996) Alcohol and hypertension. Clin Chim Acta 246:91–105

    Article  PubMed  Google Scholar 

  44. Klatsky AL (2009) Alcohol and cardiovascular diseases. Expert Rev Cardiovasc Ther 7:499–506

    Article  PubMed  Google Scholar 

  45. Klein G, Gardiwal A, Schaefer A et al (2007) Effect of ethanol on cardiac single sodium channel gating. Forensic Sci Int 171:131–135

    Article  PubMed  Google Scholar 

  46. Koskinen P, Kupari M (1991) Alcohol consumption of patients with supraventricular tachyarrhythmias other than atrial fibrillation. Alcohol Alcohol 26:199–206

    Article  PubMed  Google Scholar 

  47. Kupari M, Koskinen P (1991) Time of onset of supraventricular tachyarrhythmia in relation to alcohol consumption. Am J Cardiol 67:718–722

    Article  PubMed  Google Scholar 

  48. Lavallee RA, Williams GD, Yi H (2009) Apparent per capita alcohol consumption: national, state, and regional trends, 1970–2007. In: Alcohol epidemiologic data system surveillance report. NIAAA, Bethseda

    Google Scholar 

  49. Lovallo WR (2013) Early life adversity reduces stress reactivity and enhances impulsive behavior: implications for health behaviors. Int J Psychophysiol 90:8–16

    Article  PubMed  Google Scholar 

  50. Lovallo WR, Farag NH, Sorocco KH et al (2013) Early life adversity contributes to impaired cognition and impulsive behavior: studies from the Oklahoma family health patterns project. Alcohol Clin Exp Res 37:616–623

    Article  PubMed  Google Scholar 

  51. Lukassen J, Beaudet MP (2005) Alcohol dependence and depression among heavy drinkers in Canada. Soc Sci Med 61:1658–1667

    Article  PubMed  Google Scholar 

  52. Mackillop J, Mattson RE, Anderson Mackillop EJ et al (2007) Multidimensional assessment of impulsivity in undergraduate hazardous drinkers and controls. J Stud Alcohol Drugs 68:785–788

    Article  PubMed  Google Scholar 

  53. Nakanishi N, Makino K, Nishina K et al (2002) Relationship of light to moderate alcohol consumption and risk of hypertension in Japanese male office workers. Alcohol Clin Exp Res 26:988–994

    Article  PubMed  Google Scholar 

  54. Nephew T, Yi H, Williams G et al (2004) Alcohol epidemiologic data reference manual, Vol. 1, US apparent consumption of alcoholic beverages based on state sales, taxation, or receipt data. NIH Publication, Bethesda

    Google Scholar 

  55. NIAAA (2004) In: Services USDoHaH (ed) NIAAA council approves definition of binge drinking. Office of Research Translation and Communication; NIAAA, NIH, DHHS, Ft. Lauderdale, p 3

    Google Scholar 

  56. Nicolás J, Fernández-Solà J, Estruch R et al (2002) The effect of controlled drinking in alcoholic cardiomyopathy. Ann Intern Med 136:192

    Article  PubMed  Google Scholar 

  57. Numminen H, Hillbom M, Juvela S (1996) Platelets, alcohol consumption, and onset of brain infarction. J Neurol Neurosurg Psychiatry 61:376–380

    Article  PubMed  PubMed Central  Google Scholar 

  58. Okosun IS, Seale JP, Daniel JB et al (2005) Poor health is associated with episodic heavy alcohol use: evidence from a National Survey. Public Health 119:509–517

    Article  PubMed  Google Scholar 

  59. Peele S (1993) The conflict between public health goals and the temperance mentality. Am J Public Health 83:805–810

    Article  PubMed  PubMed Central  Google Scholar 

  60. Peter R, Siegrist J (2000) Psychosocial work environment and the risk of coronary heart disease. Int Arch Occup Environ Health 73(Suppl):S41–S45

    Article  PubMed  Google Scholar 

  61. Puddey IB, Rakic V, Dimmitt SB et al (1999) Influence of pattern of drinking on cardiovascular disease and cardiovascular risk factors – a review. Addiction 94:649–663

    Article  PubMed  Google Scholar 

  62. Rae AM, Joyce PR, Luty SE et al (2002) The effect of a history of alcohol dependence in adult major depression. J Affect Disord 70:281–290

    Article  PubMed  Google Scholar 

  63. Reed SF, Porges SW, Newlin DB (1999) Effect of alcohol on vagal regulation of cardiovascular function: contributions of the polyvagal theory to the psychophysiology of alcohol. Exp Clin Psychopharmacol 7:484–492

    Article  PubMed  Google Scholar 

  64. Rehm J, Bondy S (1998) Alcohol and all-cause mortality: an overview. Novartis Found Symp 216:223–232; discussion 232–226

    PubMed  Google Scholar 

  65. Roche AM (1997) The shifting sands of alcohol prevention: rethinking population control approaches. Aust N Z J Public Health 21:621–625

    Article  PubMed  Google Scholar 

  66. Room R, Babor T, Rehm J (2005) Alcohol and public health. Lancet 365:519–530

    Article  PubMed  Google Scholar 

  67. Rouillier P, Boutron-Ruault M-C, Bertrais S et al (2005) Alcohol and atherosclerotic vascular disease risk factors in French men: relationships are linear, J-shaped, and U-shaped. Alcohol Clin Exp Res 29:84–88

    Article  PubMed  Google Scholar 

  68. Ruigomez A, Johansson S, Wallander M-A et al (2005) Predictors and prognosis of paroxysmal atrial fibrillation in general practice in the UK. BMC Cardiovasc Disord 5:20–20

    Article  PubMed  PubMed Central  Google Scholar 

  69. Sankai T, Iso H, Shimamoto T et al (2000) Prospective study on alcohol intake and risk of subarachnoid hemorrhage among Japanese men and women. Alcohol Clin Exp Res 24:386–389

    Article  PubMed  Google Scholar 

  70. Schuckit MA, Smith TL (2006) The relationship of behavioural undercontrol to alcoholism in higher-functioning adults. Drug Alcohol Rev 25:393–402

    Article  PubMed  Google Scholar 

  71. Schulte T, Warzel F, Strasburger H et al (2001) Deficits of respiratory-cardiac coupling in heavy drinkers. Prog Neuro-Psychopharmacol Biol Psychiatry 25:1241–1256

    Article  Google Scholar 

  72. Sinha R (2001) How does stress increase risk of drug abuse and relapse? Psychopharmacology 158:343–359

    Article  PubMed  Google Scholar 

  73. Sobell LC, Sobell MB (2004) Alcohol consumption measures. Office of Research Translation and Communication; NIAAA, NIH, DHHS, Ft. Lauderdale

    Google Scholar 

  74. Steffens AA, Moreira LB, Fuchs SC et al (2006) Incidence of hypertension by alcohol consumption: is it modified by race? J Hypertens 24:1489–1492

    Article  PubMed  Google Scholar 

  75. Steptoe A, Siegrist J, Kirschbaum C et al (2004) Effort-reward imbalance, overcommitment, and measures of cortisol and blood pressure over the working day. Psychosom Med 66:323–329

    PubMed  Google Scholar 

  76. Suadicani P, Hein HO, Von Eyben FE et al (2009) Metabolic and lifestyle predictors of ischemic heart disease and all-cause mortality among normal weight, overweight, and obese men: a 16-year follow-up in the Copenhagen male study. Metab Syndr Relat Disord 7:97–104

    Article  PubMed  Google Scholar 

  77. Tarter RE, Kirisci L, Habeych M et al (2004) Neurobehavior disinhibition in childhood predisposes boys to substance use disorder by young adulthood: direct and mediated etiologic pathways. Drug Alcohol Depend 73:121–132

    Article  PubMed  Google Scholar 

  78. Taylor B, Irving HM, Baliunas D et al (2009) Alcohol and hypertension: gender differences in dose-response relationships determined through systematic review and meta-analysis. Addiction 104:1981–1990

    Article  PubMed  Google Scholar 

  79. Thatcher DL, Clark DB (2006) Cardiovascular risk factors in adolescents with alcohol use disorders. Int J Adolesc Med Health 18:151–157

    Article  PubMed  Google Scholar 

  80. Tolstrup JS, Gronbaek M, Nordestgaard BG (2009) Alcohol intake, myocardial infarction, biochemical risk factors, and alcohol dehydrogenase genotypes. Circ Cardiovasc Genet 2:507–514

    Article  PubMed  Google Scholar 

  81. Urbano Márquez A, Fernández Solà J (2004) Effects of alcohol on skeletal and cardiac muscle. Muscle Nerve 30:689–707

    Article  PubMed  Google Scholar 

  82. Urbano-Marquez A, Estruch R, Fernandez-Sola J et al (1995) The greater risk of alcoholic cardiomyopathy and myopathy in women compared with men. JAMA 274:149–154

    Article  PubMed  Google Scholar 

  83. Verdejo-Garcia A, Lawrence AJ, Clark L (2008) Impulsivity as a vulnerability marker for substance-use disorders: review of findings from high-risk research, problem gamblers and genetic association studies. Neurosci Biobehav Rev 32:777–810

    Article  PubMed  Google Scholar 

  84. Verdejo-Garcia A, Del Mar S-FM, Alonso-Maroto LM et al (2010) Impulsivity and executive functions in polysubstance-using rave attenders. Psychopharmacology 210:377–392

    Article  PubMed  Google Scholar 

  85. Volcik KA, Ballantyne CM, Fuchs FD et al (2008) Relationship of alcohol consumption and type of alcoholic beverage consumed with plasma lipid levels: differences between whites and African Americans of the ARIC study. Ann Epidemiol 18:101–107

    Article  PubMed  Google Scholar 

  86. Wakabayashi I (2011) Alcohol intake and atherosclerotic risk factors in normotensive and prehypertensive men. Am J Hypertens 24:1007–1014

    Article  PubMed  Google Scholar 

  87. Wakabayashi I (2011) Association between alcohol drinking and metabolic syndrome in Japanese male workers with diabetes mellitus. J Atheroscler Thromb 18:684–692

    Article  PubMed  Google Scholar 

  88. Wakabayashi I, Groschner K (2009) Age-dependent associations of smoking and drinking with non-high-density lipoprotein cholesterol. Metabolism 59:1074–1081

    Article  PubMed  Google Scholar 

  89. Weiss A, Gale CR, Batty GD et al (2009) Emotionally stable, intelligent men live longer: the Vietnam experience study cohort. Psychosom Med 71:385–394

    Article  PubMed  Google Scholar 

  90. Zhang Y, Post WS, Dalal D et al (2011) Coffee, alcohol, smoking, physical activity and QT interval duration: results from the third National Health and nutrition examination survey. PLoS One 6:e17584

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    William R. Lovallo

  2. Behavioral Sciences Laboratories, Department of Veterans Affairs Medical Center, Oklahoma City, OK, USA

    William R. Lovallo

Authors
  1. William R. Lovallo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to William R. Lovallo .

Editor information

Editors and Affiliations

  1. Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, USA

    Shari R. Waldstein

  2. Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands

    Willem J. Kop

  3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

    Edward C. Suarez

  4. Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    William R. Lovallo

  5. Division of Gerontology Geriatrics and Palliative Medicine Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Leslie I. Katzel

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Lovallo, W.R. (2022). Alcohol and the Cardiovascular System: Implications for Behavioral Medicine. In: Waldstein, S.R., Kop, W.J., Suarez, E.C., Lovallo, W.R., Katzel, L.I. (eds) Handbook of Cardiovascular Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-85960-6_13

Download citation

Publish with us

Policies and ethics

Search

Navigation