Home / Treating an Alcoholic With Comorbid Medical Issues / Treating Heart Disease & a Drinking Problem

Alcohol use disorder is a pattern of problem drinking that changes brain structure, leading to compulsive behaviors, intense cravings, and physical dependence on the substance. When the person is not drinking, they experience a negative emotional state and other withdrawal symptoms. Consuming large amounts of alcohol for a long time leads to serious behavioral, psychological, and physical harm. A study published in the Journal of American College of Cardiology suggested that eliminating alcohol abuse would result in 91,000 fewer individuals with congestive heart failure, 73,000 fewer instances of arterial fibrillation, and 34,000 fewer heart attacks.

The Risks of Alcohol Abuse

According to the Centers for Disease Control and Prevention (CDC), excessive alcohol consumption leads to one in 10 deaths among working-age adults, ages 20-64. Short-term health risks of alcohol abuse include:

  • Higher risk of serious injuries from falls, car accidents, etc.
  • Higher risk of violence, including perpetrating or experiencing abuse, assault, theft, homicide, or suicide
  • Alcohol poisoning
  • Risky sexual behaviors
  • High blood pressure

These can lead to long-term problems, including:

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The Relationship between Alcohol Abuse and Heart Disease

Heart disease is a term covering several conditions of the cardiovascular system, typically related to a process called atherosclerosis. This process begins when plaque builds up along the walls of arteries, reducing blood flow to and from the heart; this leads to high blood pressure. This buildup can also increase the risk of blood clots, which can cause a stroke or heart attack.

Heart problems can include:

  • Heart failure: when blood doesn’t pump from the heart as it should, leading to the body receiving less oxygen
  • Arrhythmia: changes in the heart’s rhythm, either too fast, too slow, or irregular beating
  • Heart valve problems: the valves not allowing enough blood flow or allowing blood to fall back into the heart

These conditions are serious and chronic, and when they develop, they may require lifelong treatment. Some medical studies have associated moderate consumption – less than one drink per day – of red wine with helping some heart conditions. It can improve good cholesterol, lower bad cholesterol, and reduce the risk of blood clots. However, drinking more than one five-ounce serving of wine can put a person at increased risk of heart problems. Consuming other kinds of alcohol has not been correlated with improved heart function, and drinking beyond moderate levels increases a person’s risk of all kinds of heart problems. Additionally, older adults ages 65 and older who drink beyond moderate levels of wine are at great risk for inflammation, cardiovascular disease, and death, according to a study published in the Journal of the American Medical Association (JAMA).

Heart Disease in Alcohol Use Disorder Treatment

Consuming too much alcohol, heavy drinking, and alcohol use disorder increase the risk of chronic high blood pressure. People who drink too much and consistently have high blood pressure put themselves at risk of additional heart problems. Additionally, alcohol contains a lot of calories, and drinking heavily can cause weight gain, which further stresses the heart.

Large amounts of alcohol increases the number of triglycerides in the blood – a form of fat that can increase the risk of clots. This can lead to a heart attack, stroke, or pulmonary embolism.

Binge drinking – more than four servings of alcohol in a two-hour period – also stresses the heart and increases the risk for a person developing arrhythmias. When a person binge drinks, they are at risk for alcohol poisoning, which could lead to sudden heart failure.

A particular heart condition, called alcoholic cardiomyopathy, is specifically associated with long-term alcohol abuse, usually 5-15 years of chronic, high-dose alcohol consumption. Too much alcohol weakens and thins the muscle of the heart, so it droops and cannot pump blood as effectively. This prevents major organs from receiving enough oxygen due to poor circulation. This condition most often shows up in adult men, between the ages of 35 and 50; however, more women are developing the condition.

Signs of cardiomyopathy include:

  • Shortness of breath
  • Swelling in the legs, ankles, and feet
  • Weakness
  • Exhaustion or fatigue
  • Fainting or dizziness
  • Loss of appetite
  • Difficulty concentrating
  • Coughing up mucus, especially frothy or pink mucus
  • Changes in pulse
  • Changes in urine output

A person who struggles with AUD or another form of problem drinking should, as part of their diagnosis, be screened for associated physical problems. This includes screening for heart conditions, although signs of serious heart disease may not show up for many years. Later-stage heart disease may be diagnosed before AUD or problem drinking, so clinicians should screen their patients for underlying risk factors, including alcohol abuse.

A physical exam, laboratory tests, and diagnostic tests like an echocardiogram or electrocardiogram can show whether a person struggling with AUD has heart disease or potential heart disease. Entering a medically supervised detox and rehabilitation program is important; however, people with heart conditions may need additional medical care alongside addiction treatment.

Some medications may not work for people with heart disease. For example, disulfiram, which can reduce cravings for alcohol after a person detoxes safely, can exacerbate underlying heart conditions, including those caused by alcohol abuse. Those who are working to overcome AUD, and who have a heart condition, may require inpatient treatment to keep their condition appropriately monitored. A rehabilitation program that manages prescription medications for heart conditions, or that specializes in treating medical issues in clients, can help an individual with a heart condition reach a stable place in recovery.