Binge drinking may leave your heart with more than a hangover.

As I have discussed in past blogs, patients with heart failure or other serious heart issues might do well to avoid a lot of drinking.  Sure, I know that there is a theory out there that consumption of wine is good for the heart.  But I think if you read a little about the studies that support the theory, the people they are talking about who can engage in the “moderate” consumption of wine are generally in good health.  My good health hit a speed bump and crashed about 7 years ago.

That means in my case, while I can have alcohol, it is never at the moderate level of wine or alcohol consumption.  First, I’m just not a wine connoisseur.  It is not my drink of choice, regardless of the health claims I have read about red wine for about 30 years.  I do like liquor, but I have learned that especially with heart failure, I need to avoid having alcohol become more than a once in a while thing.  Or maybe having a drink each night on the cruise, but then returning to just drinks on special occasions when I get home.  I can’t speak for other heart failure patients, but this works for me. and my doctors.
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The American Heart Association Website defines moderate alcohol consumption as an average of one to two drinks per day for men, and one drink per day for women. A drink is 12 ounces of beer, four ounces of wine, or 1.5 ounces of 80-proof spirits.  It appears to me that perhaps what the AHA deems to be moderate consumption may seem more like modest consumption.  I also think there are other factors at work that allow some people to adjust their levels:  size, overall health, proven alcohol tolerance, etc.  All of my friends in my age range know what moderate is for them and are not binge drinkers.

And what if you are young and healthy?  Is there anything wrong with more than moderate consumption of alcohol?  I think that the culture tends to shrug off alcohol use (assuming one is not an alcoholic) when you are younger because, hey what can it hurt if you’re in the prime of your life with no serious health issues?  In think the question becomes:  Are you putting a down payment on a chronic condition that will darken your doorstep later down the road and stay with you forever – like maybe heart failure? 

I bring this subject up because I know of a colleague who has a relative who was a binge drinker in college.  This person has reached the age of mid-30s and was diagnosed with heart failure.  When you think about it, mid-30s is still considered to be a young age in life.  Having been afflicted with heart failure in my mid to late fifties, I can’t even begin to imagine what it would have been like to have to deal with heart failure 20 years earlier.  Fortunately, the drug Entresto has helped this person.

I’m not trying to be judgmental here.  I was no saint in college and did some drinking, although it did not fall into the category of binge drinking.  But right after I graduated from law school, I had two episodes that might fall under the label of binge drinking.  One was right after I learned I had passed the bar exam.  My boss took me and three other law clerks (two who had also passed the bar exam) out for a celebration.  I mean isn’t that what you do when you have a happy occasion?  You celebrate with a toast or two!

Well the problem was that I was still in the process of getting to a stable weight from when I had anorexia in college.  I was very petite and probably should have stopped at a few drinks.  Making matters worse, I had not had much to eat throughout the day.  So the alcohol – and there was a lot of it, hit a pretty empty stomach.  I recall having three mixed drinks, and a glass or two of champagne in one bar.  Then we went to an Irish Pub where I finally ate a little something, but also had Guiness Stout and assorted other alcoholic drinks.  I was so plastered that my boss and one of the law clerks drove me home.  My boss made  the law clerk walk me up to my apartment, make sure I got in safely, and make sure he heard me lock the door from the other side.  The next thing I remember was waking up with a severe hangover and praying that God would just take me.  It was that bad.

The next episode was not quite this dramatic.  It occurred when I was traveling a few months later and had a few drinks on an empty stomach.  Happily, I stayed with one type of liquor that night.  While I did have a  hangover the next day, I could function.  But I swore to myself I would never, ever drink that much again, especially on an empty stomach.  I would not put myself into the category of a binge drinker, but one who learned after two times that nothing was worth the price of a hangover.

Okay, so you’re probably saying – Melanie, that’s just your experience.  At the time, you were a very skinny, maybe even undernourished person who just could not absorb the array of alcohol especially on a less than full stomach.  Fair enough.  But after doing some research, I can tell you that I am not the only one who is concerned about the perils of binge drinking among the youth of this country. 

An article posted on the American Heart Association website in June 2018 is entitled “Young binge drinkers may have higher heart risks.”  The study addressed cardiovascular risks, including high blood pressure, cholesterol and blood sugar, among 4,710 adults 18- to 45-years-old who responded to surveys in 2011-2012 and 2013-2014. Participants reported non-binge drinking, binge drinking (1-12 times yearly), or frequent binge drinking (more than12 times yearly). Then researchers compared blood pressure, cholesterol and blood sugar levels among the three groups.

The results differed a bit between the two sexes:  25.1 percent of males and 11.8 percent of females participated in high frequency binge drinking (that is, more than 12 times per year), and 29 percent of males and 25.1 percent of females participated in binge drinking 12 times a year or less.  That’s a lot of alcohol consumption.  Did it make a difference in the health of these individuals?

The short answer is yes.  For the young men, they had higher systolic blood pressure (the force on blood vessels when the heart beats) and higher blood total cholesterol than non-binge drinkers and binge drinking young women.  On the other hand, the women had higher levels of blood sugar than non-binge drinking women.  The article said that all results persisted even after considering diet and physical activity.

The article noted that the study showed only an association, not a cause and effect relationship, between binge drinking and cardiovascular risk factors.  However, an association is still enough to require careful consideration of future impacts.  This is why the article also noted that “Young adults should be screened and counseled about alcohol misuse, including binge drinking, and advised on how binge drinking may affect their cardiovascular health.”

I also noticed that the website for the Centers for Disease Control (CDC) has a Vital Signs webpage.  In January 2013, they posted an article entitled “Binge Drinking”  A Serious, Under-Recognized Problem Amount Women and Girls.”  It noted the following statistics and facts:

Nearly 14 million US women binge drink about 3 times a month.

• Women average 6 drinks per binge
• 1 in 5 high school girls binge drink
• Women’s and girls’ bodies respond to alcohol differently than men’s. It takes less alcohol for women to get intoxicated because of their size and how they process alcohol.

 
After citing these statistics, the following comment caught my attention:  “Binge drinking is a dangerous behavior but is not widely recognized as a women’s health problem”.   To me the danger is two-fold.  Young women and girls may be less able to make informed decisions when they are binge drinking.  Additionally, if it takes less alcohol for women and girls to become intoxicated, I would have to think it is probably that it also takes less alcohol to inflict life-long, irreversible health damage on women and girls as well.  It was helpful that the CDC included a four page fact sheet that provides much useful information about the problem and what can be done to start to resolve the problem.

Additionally, I found an April 26, 2017 article on the Men’s Health website entitled:  “Think about this the next time you’re tempted to throw back a few shots.”  This article focused on a study published in the European Heart Journal.  This study involved more than 3,000 people over 16 days at the 2015 Munich Octoberfest.  They drank differing amounts of alcohol during the day. The study participants were an average age of 35, and ranged from having none to three grams of alcohol per kilogram of blood (the equivalent of drinking 202 ounces of beer for slim people and 338 ounces for larger people). Electrocardiograms (ECGs) were used to monitor their heart activity using and a breathalyzer was used to test their breath alcohol concentrations.

The article said: 

• While the study points out that about one to four percent of the general population has cardiac arrhythmias, i.e. irregular heartbeats, 30.5 percent of study participants had irregular heartbeats and nearly 30 percent of them were sinus tachycardia, a condition where the heart beats too fast. Scientists found a direct link with alcohol: People who had higher blood alcohol levels were at a significantly increased risk of having a heart arrhythmia. 

Having lived for the past five years with irregular heartbeats, I can tell you it is a condition that needs to be carefully monitored or you could have serious issues.  I would do anything possible to cure it but I suspect I’m stuck with it for the rest of my life.  In fact with the irregular heartbeats I experience with little if any alcohol in my system, I can’t imagine how wildly erratic it might be with over 202 ounces of alcohol in my body!

In reading through these articles, it struck me that the danger of binge drinking is two-fold.  First, there is the immediate danger, which is stated in a September 2019 story on the CBS News website entitled “From Binge Drinking to Blacking Out, the Disturbing Epidemic Putting America’s Kids in Danger.”  This story focuses on what it calls the pervasive and problematic drinking culture among American Youth.  The  story discussed a CBS News Documentary called:  “Drinking Culture”  the American Kids and the Danger of Being Cool.”  I did not watch the documentary, but it apparently discussed some of the influences in the United States that have resulted in more young females becoming binge drinkers. 

Unfortunately, from some of what I read, I think the drinking surpasses being cool and turns into being comatose.  Why do I say this?  Because here is an excerpt fo the interview with one female college senior who:  “…told producers that the most she's had to drink in a night was 15 drinks. When pressed on what that was like, and whether or not she remembered that night, she shook her head, laughed a little bit, and replied, "No. I blacked out."

To me, one of the best parts of life is accruing experiences that you can remember, build upon and learn from and even cherish.  But I suspect that this no memory result is indicative of what most binge drinkers experience.  As the story points out:  “Not only does this sort of normalized underage drinking behavior put American teens at greater risk of physical injury and sexual assault, experts point out that there are biological consequences to drinking in excess before the brain is done developing.”

So there is the short term danger of being in a position where you are taken advantage of and harmed, and the long term consequences to your brain.  But there is also what damage you may be inflicting on your heart and other organs long term.  How does one communicate the danger of this damage to someone who is young and feels invincible?  If only there was a way to simulate for the binge drinker might the continuing experience of shortness of breath, fatigue and confusion that one experiences when the heart and other organs begin to fail. 
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We’ve all been the victim of the occasional hangover.  But if the hangovers and amnesia become the norm, maybe it’s time to make a down payment on a healthy body and switch to a more moderate, methodical drinking habit.