Alcohol abuse is as old as mankind. Human beings have always had a desire to use substances that make them feel relaxed, stimulated, or euphoric. Alcohol is one of the substances that does just that. It was known to mankind for ages. Unfortunately, alcohol is also addictive. Today, alcohol addiction has assumed enormous proportions especially for a small place like Goa. The state excise department disclosed in 2012 that it had issued 6,918 liquor bar licenses in Goa. With liquor being cheaper here as compared to other states, the large number of bars comes as no surprise. If we assume that the state’s population is around 14 lakhs, then there is a bar for every 200 men, women and children.
Goa-based studies reveal that while moderate alcohol intake is in general associated with higher education and better socio-economic circumstances, harmful alcohol use is seen more often in males who are less educated and poor. There is a strong association between harmful use of alcohol and factors such as psychological difficulties and violence. Every year around 5,000 new patients in Goa reportedly receive treatment for alcohol abuse and related diseases, out of which around 500 die of various complications.
Moderate and severe consumption
Moderate alcohol consumption is defined as having up to 1 drink per day for women and up to 2 drinks per day for men. (A drink is 12 oz. of beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits, or 1 oz. of 100-proof spirits.). Heavy drinking is typically defined as consuming 15 drinks or more per week for men and eight drinks or more per week for women. “Binge drinking” means five or more drinks on a single occasion for men and four or more drinks on a single occasion for women, consumed generally within the space of 2 hours or less.
Alcohol and the heart
Alcohol may induce asymptomatic dysfunction of the left ventricle even when it is ingested in healthy individuals in relatively small quantities (as occurs in subjects who are considered “social drinkers”). With continued heavy alcohol ingestion a condition called “dilated cardiomyopathy” can occur wherein the heart enlarges triggering symptoms and signs of heart failure. This occurs in men who have consumed more than 80 g of alcohol (i.e., 1 liter of wine, eight standard-sized beers, or one-half pint of hard liquour) per day for at least 5 years. Women appear to be even more susceptible than men and may develop the above illness following the consumption of smaller amounts.
Individuals who consume severe amounts of alcohol may also be susceptible to “substantial” rise of blood-pressure. Even “social” alcohol consumption may be associated with a “modest” rise in blood-pressure.
Alcohol intake also disturbs our blood fats. Most commonly it causes an increase in “blood triglycerides”. Heavy ingestion, however, may also cause an increase in total serum cholesterol which, more than triglycerides, is associated with heart blockages. Interestingly, however, regular alcohol consumption favorably increases your HDL cholesterol (good cholesterol) which is coronary protective. But no doctor would recommend alcohol to teetotalers for the sake of increasing HDL – considering the deleterious effects of alcohol on several other body organs.
Many large studies have revealed that moderate alcohol intake is associated with a reduced risk of heart attacks in Western population (but not necessarily in Indians). Red wine is said to be salutary because it contains resveratrol, which is an antioxidant. This apparently explains the “French paradox”. The French were noted to have a reduced incidence of heart blockages compared to inhabitants of other countries despite high smoking rates and a diet high in fat.
Alcohol consumption may play havoc with your heart beat. Various types of irregularities of the heart beat (especially “atrial fibrillation”) have been associated with alcoholism. Most episodes can occur after “binge drinking”. When it typically happens on weekends or holidays it is referred to as the “holiday heart”.
Sudden death due to alcohol (a dreaded complication) can occur in an individual even in the absence of a heart attack. But here too while moderate amounts of alcohol may be protective against sudden death, heavy alcohol consumption leads to an increased incidence of sudden death. Those who are aged and ingest more than 80 g of alcohol per day reportedly have a threefold increased incidence of sudden mortality.
As far as alcohol intake is concerned, it is best to be a teetotaler, that is, not to take alcohol at all. Should, however, anyone decide to enjoy its pleasurable effects then the key is moderation.
(Dr. Francisco Colaço is a most
consulting physician and pioneer of echocardiography in Goa)
