Alcohol Drinking
A standard drink is about the equivalent of 12 ounces of beer, 5 ounces of wine, 8 ounces of malt liquor or 1.5 ounces of 80-proof distilled spirits. Moderate drinking is defined as no more than two drinks a day for men and one per day for women. Binge drinking is the consumption of five or more drinks on one occasion for men and 4 or more drinks for women.

According to the Centers for Disease Control and Prevention, about 50 to 60 percent of American adults drink alcohol. Roughly 20 percent of adults binge drink. Binge drinking is a serious problem on college campuses. The National Institute on Alcohol Abuse and Alcoholism found more than 40 percent of college students reported binge drinking at least once during a 2-week period. The problem hits younger people as well. In a survey by the National Clearinghouse for Alcohol and Drug Information, 8 percent of youth 12 to 17 reported binge drinking in the last 30 days.

Consequences of Binge Drinking
Research suggests occasional, moderate consumption of alcohol may reduce the risk for heart disease. But excessive use of alcohol can be dangerous, increasing the risk for automobile accidents, injury, assault, sexually transmitted disease and unintentional pregnancy. Students who binge drink are more likely to miss classes, engage in unlawful behavior or become a crime victim. The Center for Science in the Public Interest reports 30,000 college students require medical treatment for alcohol overdose annually.

Now researchers are finding binge drinking can also be bad for your heart. In fact, John Cullen, Ph.D., Vascular Biology Researcher with the University of Rochester Medical Center, says the risk for a heart attack doubles after binge drinking. Cullen says the first clues to the problem came when doctors noted an increase in heart-related hospital admissions on Monday. Further investigation found many of these patients were binge drinking over the weekend.

The key component in the link between binge drinking and heart risk appears to be a chemical called acetaldehyde, formed when the liver breaks down alcohol. This chemical causes an increase in the production of immune system white blood cells called monocytes. The monocytes have receptors that cause the cells to be attracted to the walls of the arteries, where they may engorge with cholesterol and promote the development of plaque.

Normally, when a person drinks, the body produces other substances to neutralize the acetaldehyde. But when too much alcohol is consumed, the body can’t eliminate the acetaldehyde fast enough and levels accumulate.

Cullen says after a bout of binge drinking, the concentration of acetaldehyde remains elevated for 12 to 14 hours. Inside the blood vessels, high levels of the chemical may actually destabilize plaque deposits, increasing risk for plaque rupture in the coronary arteries. The body may sense this as an injury and send clotting factors to “seal” the damage, leading to a blockage in the artery and potential heart attack. In some cases, pieces of the plaque may break off and travel through the circulatory system, causing a blockage elsewhere in the heart or in the brain (a stroke).

Currently, Cullen and his colleagues are using animals to study how acetaldehyde destabilizes arterial plaque and increases the risk of plaque rupture. Those findings may provide clues as to how excessive alcohol affects the blood vessels in humans and increases the risk for a heart attack.

AUDIENCE INQUIRY
For general information on binge drinking and its health effects:
Centers for Disease Control and Prevention, http://www.cdc.gov/alcohol
National Institute on Alcohol Abuse and Alcoholism, http://www.niaaa.nih.gov, or http://www.collegedrinkingprevention.gov
SAMHSA, National Clearinghouse for Alcohol and Drug Information, http://ncadi.samhsa.gov

BIBLIOGRAPHY
Hijmering, M., et al., “Binge Drinking Causes Endothelial Dysfunction, which is not Prevented by Wine Polyphenols,” The Journal of Medicine, January 2007, Vol. 65, No. 1, pp. 29-35.

Mukamal, Kenneth, M.D., et al, “Alcohol Consumption and Risk for Coronary Heart Disease in Men with Healthy Lifestyles,” Archives of Internal Medicine, October 23, 2006, Vol. 166, No. 19, pp. 2145-2150.

Pletcher, Mark, et al., “Alcohol Consumption, Binge Drinking, and Early Calcification,” American Journal of Epidemiology, March 1, 2005, Vol. 161, No. 5, pp. 423-433.

“Socioeconomic Differences in Binge Drinking Among Adults – 14 States, 2004,” MMWR: Morbidity and Mortality Weekly Report, April 3, 2009, Vol. 58, No. 12, pp. 301-304.

Van de Wiel, A., and D.W. de Lange, “Cardiovascular Risk is More Related to Drinking Pattern than to the Type of Alcoholic Drinks,” The Journal of Medicine, December 2008, Vol. 66, No. 11, pp. 467-473.

Yang, Seungmi, et al., “Socioeconomic and Psychosocial Exposures Across the Life Course and Binge Drinking in Adulthood,” American Journal of Epidemiology, January 15, 2007, Vol. 165, No. 2, pp. 184-193.

Research compiled and edited by Barbara J. Fister