Effects of Alcohol on the Cardiovascular System

Alcohol affects both the heart and the peripheral vasculature. Acutely, alcohol causes peripheral vasodilatation, giving a false sensation of warmth that can be dangerous. Heat loss is rapid in cold weather or when swimming, but reduced awareness leaves people vulnerable to hypothermia. The main adverse effect of acute alcohol on the cardiovascular system is the induction of arrhythmias. These are often harmless and experienced as palpitations but can rarely be fatal. Chronic ethanol consumption can cause systemic hypertension and congestive cardiomyopathy. Alcoholic cardiomyo-pathy accounts for up to one-third of dilated cardiomyopathies but may improve with abstinence or progress to death.

The beneficial, cardioprotective effects of alcohol consumption have been broadcast widely. This observation is based on population studies of mortality due to ischemic heart disease, case-control studies, and animal experiments. However, there is no evidence from randomised controlled trials. The apparent protective effect of alcohol may therefore result from a confounding factor. Furthermore, on the population level, the burden of alcohol-induced morbidity and mortality far outweighs any possible cardiovascular benefit.

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