Women who drink may be at greater risk of cardiovascular complications than men

September 14, 2003

The cardiovascular effects of chronic, heavy alcohol consumption can include an increased prevalence of hypertension, cardiomyopathy, arrhythmia, and stroke. Most of the studies to date, however, have focused on males, even though women appear to be more sensitive than men to alcohol's toxic effects on the heart. Research published in the September issue of Alcoholism: Clinical & Experimental Research confirms that some female alcoholics experience more severe cardiovascular effects from heavy alcohol drinking than those observed in male alcoholics, and these effects are noted at an earlier stage of drinking and at a lower consumption level than those noted in men.

"This work adds to the growing body of literature that confirms what many researchers in the field have suspected," said Nancy C. Bernardy, a research psychologist at the National Center for PTSD in White River Junction, Vermont. "The use of drugs, such as alcohol and nicotine, has a greater adverse impact on women than on men."

This phenomenon - where women need to drink a lesser amount of alcohol than men do, or for a shorter amount of time, to produce the same degree of damage - is referred to as "telescoping."

"Additionally," said Bernardy, also the first author of the study, "I think that this work adds to growing evidence that there are subtle differences in the cardiovascular systems of women in general compared to those of men. Women's hearts are not just smaller versions of men's. Their cardiovascular systems respond differently, and this is particularly true in response to stress and toxins like alcohol.

Women need to know that they may be exposing themselves to a greater risk of heart disease than the risk noted in men by their behaviors as well as the way they handle stress."

This study looked at 32 inpatient female alcoholics, abstinent for four weeks, and 16 female social drinkers. Researchers examined the participants' blood pressure, heart rate, stroke volume and vascular resistance during rest and in response to two stress tests: a five-minute hand grip task, and a five-minute speech exercise.

The alcoholics were then divided into subgroups according to their withdrawal blood pressures: those with transitory hypertension (tHT), occasional above-normal blood pressure that normalized after withdrawal, and those with normal blood pressure throughout withdrawal and treatment.

"The women with tHT showed dysfunction across most of the cardiovascular measures," said Candice M. Monson, assistant professor of psychiatry at Dartmouth Medical School. "The alcohol-dependent women who experienced hypertension related to detoxification also showed a protracted pattern of cardiovascular dysfunction after a period of abstinence from alcohol. This is in contrast to previous studies showing that men with tHT return to 'normal' resting cardiovascular functioning after a period of abstinence, and manifest cardiovascular dysfunction only when faced with an aversive stressor. Furthermore, this finding is congruent with recent studies showing that cardiovascular effects in women are more severe than in men, and emerge sooner with chronic drinking."

Both Bernardy and Monson noted that these findings suggest that a subgroup of women may compromise, perhaps irreparably, their cardiovascular systems through chronic, heavy alcohol consumption.

"The short-term implication of this dysregulation may be evidenced as an increased risk for the development of hypertension," said Bernardy, "with the long-term implication of an increased risk for the development of future cardiovascular disorders such as heart attacks, strokes, or cardiomyopathy."

"This research is to be applauded for furthering our understanding of the consequences of women's substance abuse," said Monson. "For years, women's alcohol use and its consequences has been sorely understudied and neglected. A one-size-fits-all, or perhaps more aptly put, a male-size-fits-all approach has been applied to women. In fact, this study, along with other recent studies, shows that women's alcohol-use patterns and their consequences are different from men."

Bernardy is hopeful that these findings will generate more research on the cardiovascular consequences of heavy drinking in women. "The average reader may be confused since she has heard that one or two drinks a day may be beneficial for her cardiovascular system.

Although this appears to be true, we don't know which of these social-drinking women may be prone to developing chronic heavy drinking down the road. Some of these women may experience fairly rapid health complications from alcohol misuse. That is the message that we need to convey."
-end-
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper included Andrea C. King of the Department of Psychiatry at the University of Chicago; and William R. Lovallo of the Behavioral Sciences Laboratories at Veterans Affairs Medical Center, and the Department of Psychiatry and Behavioral Sciences at the University of Oklahoma Health Sciences Center. Oklahoma City. The study was funded by the National Institute on Drug Abuse, and the Oklahoma City Veterans Affairs Medical Center.

Alcoholism: Clinical & Experimental Research

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