Cochin Cardiac Club

Health Blog by Dr.Uday Nair


Alcohol consumption and tobacco use have been associated with a wide variety of cardiovascular diseases, although these associations include both detrimental and (at least for moderate drinking) some potentially beneficial effects. Alcohol intake of three or more drinks per day and cigarette smoking share similar, and probably additive, adverse effects on some forms of cardiovascular disease. Examples of these adverse effects include increases in blood pressure and levels of triglycerides in the blood and higher risks of stroke and congestive heart failure. On the other hand, there is relatively little evidence that the two act synergistically or that the effects are worse when smoking and drinking occur together than would be expected from their independent effects. In most cases, more moderate drinking does not share these risks and even has effects opposite those of cigarette smoking on HDL-C and blood clotting. Nonetheless, because alcohol and tobacco are used together and in excess so commonly, their joint effects are encountered widely throughout the population. Ongoing public health efforts to minimize tobacco use and harmful drinking should result in clear and important gains to the nation's cardiovascular well-being



The effects of smoking vary from person to person as it will depend on the person's vulnerability to the chemical in cigarette or tobacco smoke. It will also depend on the number of cigarette sticks a person smokes per day, the age when the person first started to smoke, and the number of years the person has been smoking. Here are some of the different effects of smoking:
  • Heart: The effects of smoking on your heart are devastating. Nicotine raises blood pressure and makes the blood clot more easily. Carbon monoxide robs the blood of oxygen and leads to the development of cholesterol deposits on the artery walls. All of these effects add up to an increased risk of heart attack.
  • Lungs: Smoking causes chronic obstructive pulmonary disease (COPD), a group of diseases that includes emphysema, chronic bronchitis and asthmatic bronchitis. COPD is called the "silent killer." Many smokers don't know they are affected until it is too late. There is no cure for these diseases and no way to reverse the damage. Ten percent to 15% of all smokers will develop COPD.

  • Blood Circulation: A major effect of smoking is that veins and arteries get narrower, harder and coated with fatty deposits. This can lead to problems such as:
    • Low fitness, cold skin, hands and feet, and ulcers.
    • Gangrene which leads to amputations.
    • Cramps, pains and blockages in your veins which can cause strokes and heart attacks.

  • Bones: Smoking can cause bones to get weak and brittle. Women need to be especially careful because they are 5 to 10% more likely to suffer from osteoporosis than non-smokers.

  • Stomach: The damage to your stomach area can affect your vital organs. You have increased chances of getting stomach cancer or ulcers. You are also at risk of developing cancers in your kidney, pancreas and bladder.

  • Mouth and Throat: Smoking causes unattractive problems like bad breath and stained teeth. It can also cause gum disease and damage to your sense of taste. The most serious damage smoking causes in this area is an increased risk of cancer in your lips, tongue, throat, voice box and oesophagus (gullet).

  • Eyes: Dangerous smoking effects on eyes include common eye diseases such as Graves' ophthalmopathy, age-related macular degeneration, glaucoma and cataract. The worst smoking effect on eyes can be permanent blindness.

  • Skin: Smoking reduces the amount of oxygen to the skin. This means that the skin ages more quickly and looks grey and dull. The toxins in your body also produce cellulite.

  • Reproduction and Fertility: The effects of smoking on reproduction and fertility are serious. Smoking can increase the risk of impotence. It can also damage sperm, reduce sperm count and cause testicular cancer.Pregnant women who smoke are more likely to suffer miscarriage and stillbirth.
Passive smoking-

Smoking not only harms you but also those around you. Adults who breathe in other people's smoke also have an increased risk of lung cancer and heart disease. Children who breathe in other people's smoke are more likely to develop lung diseases like asthma, bronchitis and pneumonia, and their physical growth and intellectual development can also be affected.


The long term effects of alcohol range from possible health benefits for low levels of alcohol consumption to severe detrimental effects in cases of chronic alcohol abuse. High levels of alcohol consumption are correlated with an increased risk of developing alcoholism, cardiovascular disease, malabsorption, chronic pancreatitis, alcoholic liver disease, and cancer. Damage to the central nervous system and peripheral nervous system can occur from sustained alcohol consumption. Long-term use of alcohol in excessive quantities is capable of damaging nearly every organ and system in the body. The developing adolescent brain is particularly vulnerable to the toxic effects of alcohol.
Historically doctors have promoted alcohol for its perceived health benefits and most recently for protection against coronary heart disease. There is evidence of cardiovascular benefits from drinking 1 - 2 drinks per day; however, the health benefits from moderate intake of alcohol are controversial. Concerns have been raised that, similarly to the pharmaceutical industry, the alcohol industry has been involved in exaggerating the health benefits of alcohol. Alcohol should be regarded as a recreational drug with potentially serious adverse effects on health and it is not recommended for cardio-protection in the place of safer and proven traditional methods such as a balanced diet, exercise and pharmacotherapy.
Some experts argue that the benefits of moderate alcohol consumption may be outweighed by other increased risks, including those of injuries, violence, fetal damage, certain forms of cancer, liver disease and hypertension. As the apparent health benefits of moderate alcohol consumption are limited for populations at low risk of heart disease, other experts urge caution because of the possibility that recommending moderate alcohol consumption may lead to an increased risk of alcohol abuse, particularly among the young.The benefits of moderate alcohol consumption may be outweighed by the risks of moderate alcohol consumption.


Alcohol and cardiovascular disease

Studies have found that there is a reduced risk of mortality from coronary heart disease in persons who drank 1 - 2 drinks per day.Studies in  randomized trials found that alcohol consumption in moderation decreases serum levels of fibrinogen, a protein that promotes clot formation and increases levels of tissue type plasminogen activator, an enzyme that helps dissolve clots.The serum levels of C-reactive protein (CRP), a marker of inflammation and predictor of CHD risk, are lower in people who drink moderately than those who abstain from alcohol suggesting that alcohol consumption in moderation might have anti-inflammatory effects. In addition to its psychotropic properties, alcohol has anticoagulation properties similar to warfarin. Additionally, thrombosis is lower among moderate drinkers than teetotalers.
Despite epidemiological evidence, some criticize the idea of recommending alcohol for health benefits. But recommending moderate alcohol consumption for health benefits is "ridiculous and dangerous".There have been no randomised controlled trials to demonstrate the cardio benefits of alcohol. Due to the risks of abuse, dependence, adverse effects, alcohol should never be recommended for cardio benefits as a substitute to well-proven measures, such as a good diet, exercise or pharmaceutical drugs. It has been argued that the health benefits from alcohol are at best debatable and may have been exaggerated by the alcohol industry. Alcohol should be regarded as a recreational drug with potentially serious adverse effects on health and should not be promoted for cardio-protection.

  • Peripheral Arterial Disease

"Moderate alcohol consumption appears to decrease the risk of PAD in apparently healthy men."In this large population-based study, moderate alcohol consumption was inversely associated with peripheral arterial disease in women but not in men. Residual confounding by smoking may have influenced the results. Among nonsmokers an inverse association was found between alcohol consumption and peripheral arterial disease in both men and women."
  •  Heart attack and stroke
Drinking in moderation has been found to help those who have suffered a heart attack survive it. However, excessive alcohol consumption leads to an increased risk of heart failure.A review of the literature found that half a drink of alcohol offered the best level of protection. However, they noted that at present there have been no randomised trials to confirm the evidence which suggests a protective role of low doses of alcohol against heart attacks.However, moderate alcohol consumption is associated with hypertension. There is an increased risk of hypertriglyceridemiacardiomyopathyhypertension, and stroke if 3 or more standard drinks of alcohol are taken per day

  • Cardiomyopathy

Large amount of alcohol over the long term can lead to alcoholic cardiomyopathy. Alcoholic cardiomyopathy presents in a manner clinically identical to idiopathic dilated cardiomyopathy, involving hypertrophy of the musculature of the heart that can lead to congestive heart failure.


For those who have alcohol in moderate amounts,please do reduce your intake,exercise regularly and check your cholesterol(lipid profile)  blood and urine once in 6 months.

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