teaser
History of repeated binge drinking in healthy young adults caused alterations in macro- and microvascular function similar to those seen in individuals with recognised cardiovascular risk factors, according to a study published April 23 in the Journal of the American College of Cardiology (JACC).
Researchers at the University of Illinois at Chicago compared 19 men and women ages 18 to 25 years with normal serum lipoproteins, triglycerides, CRP, glucose, and insulin levels who had a history of binge drinking to 17 healthy young adults in the same age range who consumed no more than five drinks within the last year (abstainers). Binge drinking was defined as having five or more standard alcoholic drinks within two hours for men, and four or more standard drinks within two hours for women. The binge drinkers in this study had an average of six binge-drinking episodes within the past month and an average four years of binge-drinking behaviour.
Results found that the binge drinkers had significantly lower brachial artery endothelial-dependent flow-mediated vasodilation (FMD) (8.4 percent lower; p=0.022) and nitroglycerin-mediated dilation (NTG) (19.6 percent lower; p=0.009) 24 to 96 hours after the most recent binge-drinking episode, compared to abstainers. The FMD impairments are equivalent to those found in individuals who have a lifetime history of daily heavy alcohol consumption (> 6 drinks/day for > 8 years), the researchers said. In addition, the reductions in NTG dilations suggest that there could be “reduced smooth muscle cell responses to NO and altered post-receptor signal transduction events, such as alterations in the cyclic guanosine monophosphate pathway.” There were no differences between groups in terms of blood pressure, lipoproteins, and Creactive protein.
According to Ralph Brindis, MD, MPH, MACC, past president of the ACC, the study suggests a fascinating paradox between epidemiologic evidence of a protective effect of modest to moderate alcohol use versus the potentially adverse effect of chronic binge alcohol drinking for the development of cardiovascular disease. “The authors have extended the number of well-known hazards of acute and chronic binge alcohol drinking, such as severe respiratory depression, aspiration, motor vehicle accidents and even death, to include alterations in both macro- and microvascular function,” he said. “Previous studies have shown that impaired microvascular function may be a risk factor for the development of cardiovascular disease.”
Moving forward, the study authors suggest a potential need to screen young adults for a history of binge drinking when looking at risk factors for cardiovascular disease. Robert A. Vogel, MD, FACC, writes in an accompanying JACC editorial that additional studies should also look at moderate, steady young drinkers and study the time course of vascular function immediately after cessation of intake, as well as after longer abstinence — something the current study does not explore. “Why alcohol, a vasodilator, might cause a persistent vasoconstrictive state days after cessation of intake remains unclear,” he notes.
