Reported by Stephanie Nebehay, Postmedia News

In its first report on alcohol since 2004, the World Health Organization reported that alcohol causes nearly 4% of all deaths worldwide, more than AIDS, TB, and violence.

In its “Global Status Report on Alcohol and Health,” WHO reported that 2.5 million people die yearly from alcohol related causes.

Rising incomes have resulted in heavier drinking in high population areas in Africa and Asia, including India and South Africa, with binge drinking on the rise.

Weak governmental policies to control drinking have failed to curb the increase in alcohol use, creating rising rates of spousal and child abuse, homicides, random violence, alcohol-induced disease, and job absenteeism.

Particularly affected are younger populations: Alcohol is the leading risk factor for death among males 15-59. Binge drinking is a particular problem since it leads to risky behaviors. 11% of drinkers are drunk once a week, with men predominating four to one.

Alcohol is a causal factor in sixty types of diseases and injuries. WHO ministers agreed to adopt a policy of higher taxes and tighter marketing restrictions on alcohol sales.

New since its last report, is the confirmed relationship between alcohol and breast cancer. Also, it now appears that the beneficial effect of moderate drinking on heart health disappears with occasions of heavy drinking.

Alcohol consumption is highest in developed countries and lowest in areas of large Muslim populations who abstain from drinking.

Homemade or illegally produced alcohol that falls outside government controls and tax nets accounts for nearly 30% of total worldwide production. Some is toxic

Note: Several years ago my wife and I visited the Solomon Islands on a medical mission. The natives make their own alcoholic drink from fermented coconut known as “Kwazo” which is so potent it is also known as “rocket fuel”. 

FEBRUARY 1, 2011

IS ALCOHOL GOOD FOR THE HEART?

I had lunch with an old running buddy last week.  He has nineteen years of sobriety (I am envious). I hadn’t seen him in a year and I was surprised to find out he had narrowly escaped a severe heart attack, had extensive tests and was found to have 80% occlusion (blockage) of his left anterior descending coronary artery and an 85% occlusion of his left circumflex. That’s two out of three bad arteries. He had the blockages opened up by placing a spring like apparatus called a stint in each artery. He is running again (I am doubly envious) and everything is fine.

“Do you have any heart disease in your family?”

“ I don’t know. They all died of alcoholism before they were old enough to get heart disease.”

“Really?”

“ Well, that’s not really true. My father died of congenital heart failure at fifty-four.”

My friend’s father was a daily black out drinker. He didn’t die of congenital heart failure. Congenital heart disease is structural abnormalities seen at birth. His father died of congestive heart failure. It was almost certainly caused by alcohol.

But wait, you say. I thought alcohol was good for the heart. Isn’t that what you read all the time in the paper and hear on the news?

There are studies that show that moderate alcohol intake improves heart longevity. However, if you read how they define “moderate” you will find that you know very few people who drink that little. Moderate is defined as one to one-and-a-half ounces of alcohol. That’s eight to twelve ounces of wine or two beers.

In higher doses, alcohol is toxic to the heart; it actually kills myocardial or heart muscle cells, just like it kills liver cells and nerve cells. The result is a little scar where that myocardial cell was. Over time, there are more and more scars and less and less myocardial cells.

The disease is called alcoholic cardiomyopathy, which translates into “heart muscle disease”. With less functioning muscle, the strength of the heart’s contraction diminishes, and the drinker experiences decreased exercise tolerance. It’s no different than if he had a massive heart attack and killed a large amount of heart muscle.

With progression, the alcohol-damaged heart can’t keep pace with the blood returning to the left heart from the general circulation and to the right heart from the lungs. The result is the backing up of fluid in the arms and legs producing edema or swelling and in the lungs causing congestion or pulmonary edema. The lungs are so filled with fluid that the blood cannot be oxygenated. The drinker is literally drowning in his own fluid.

A half-dozen times during my internal medicine internship at Los Angeles County-U.S.C. Medical Center, I had to treat severe congestive heart failure. Two of those were from alcoholic cardiomyopathy.

These patients arrived in the admitting ward extremely agitated and gasping for breath, even on oxygen. They had blood-tinged foamy bubbles dripping from their noses and mouths. Their chest sounds were gurgles as the air tried to make its way through the fluid. From the look on their faces, they were feeling impending doom.

            With quick action, powerful diuretics, and heart strengthening drugs, we were able to save five of the six. But with their weakened hearts, they would be back again, and again. Almost certainly they would succumb to their disease: congestive heart failure.

February is American Heart Month. Although it may be true that small doses of alcohol decrease heart disease, it is important that the unwary public who has heard only one side of the story learn that moderate (by my definition) and heavy drinking may have the opposite effect.

You be the judge.

jh